Vetebral hemangiomas: spinal angiography and preoperative embolization

Area of Science:

• Neurosurgery
• Interventional Radiology
• Vascular Medicine

Background:

• Spinal hemangiomas are benign vascular tumors that can cause significant neurological deficits.
• Symptomatic presentation necessitates intervention, often surgical resection.
• High vascularity of hemangiomas poses a surgical challenge due to potential for significant blood loss.

Observation:

• Seven cases of symptomatic spinal hemangiomas were reviewed.
• One case required pre-operative embolization to manage tumor vascularity.
• Embolization aimed to decrease the arterial supply to the hemangioma prior to surgical removal.

Findings:

• Pre-operative embolization achieved a marked reduction in the blood supply to the spinal hemangioma.
• The embolization procedure facilitated a technically less demanding laminectomy.
• Surgical intervention following embolization was performed without significant intraoperative complications related to bleeding.

Implications:

• Pre-operative embolization is a valuable adjunct in managing highly vascular spinal hemangiomas.
• Reducing tumor vascularity pre-operatively can enhance surgical safety and reduce operative time.
• This approach may improve outcomes for patients undergoing surgical treatment for symptomatic spinal hemangiomas.