Purpose: The authors retrospectively reviewed their 4-year clinical experience to determine the role of transarterial embolization in the treatment of symptomatic vertebral hemangioma.
Patients and methods: Eight patients (age range, 12-56 years) underwent a total of 10 embolization procedures; one patient underwent three procedures. The lesions were located between T-5 and L-5, and all patients presented with pain and symptoms referable to the lower extremities.
Results: Embolization was technically successful in all patients, and no complications were encountered. Six of eight patients underwent surgery within 48 hours of embolization; four of the six showed significant clinical improvement immediately after surgery and on follow-up (average, 34 months). Two patients did not improve postoperatively. Two patients initially underwent embolization as the sole therapy. The first refused surgery and did not improve clinically; the second underwent two embolization procedures without clinical improvement and eventually underwent a third followed by surgery, which resulted in clinical improvement. All patients were hemodynamically stable during surgery, and blood loss was not problematic in any patient.
Conclusions: Overall, surgery was an effective treatment for symptomatic vertebral hemangioma and the authors conclude that transarterial embolization of vertebral hemangioma is a safe and efficacious adjunctive procedure to such surgery. However, embolization was not as promising as a sole therapeutic modality in this small group of patients.