Long-Term Outcome of Surgical Management in Symptomatic Pediatric Vertebral Hemangiomas Presenting With Myelopathy

Neurosurgery. 2020 Nov 16;87(6):1240-1251. doi: 10.1093/neuros/nyaa273.

Abstract

Background: Vertebral hemangiomas are benign, highly vascular lesions of the vertebra, rarely seen in the pediatric age group.

Objective: To analyze the long-term (>3 yr) outcome of patients of pediatric vertebral hemangioma presenting with myelopathy and to describe our surgical strategy to treat such cases.

Methods: All patients up to 18 yr of age with a symptomatic vertebral hemangioma treated at our hospital from May 2003 to August 2016, with at least 3-yr follow-up were included. Functional clinical outcomes were measured using American Spinal Injury Association (ASIA) score.

Results: There were 7 male and 7 female patients. All hemangiomas were located in the thoracic spine with single-level involvement. Upper thoracic spine involvement was more common (12 cases: 85.71%) than lower thoracic spine involvement (2 cases: 14.29%). All patients had features of myelopathy. The mean age was 14.57 yr, ranging from 10 to 18 yr. The mean follow-up was 62.21 mo, ranging from 36 to 90 mo. All patients had improvement in motor strength of both lower limbs postoperatively. Local pain, which was present in 1 patient, resolved, and the bladder symptoms present in 5 patients also resolved.

Conclusion: Our experience in treating symptomatic pediatric vertebral hemangiomas, along with the long-term follow-up data, suggests that good postoperative results can be achieved with minimal complications in carefully selected patients.

Keywords: Absolute alcohol; Myelopathy; Pediatric; Vertebral hemangioma.

MeSH terms

  • Adolescent
  • Child
  • Decompression, Surgical
  • Female
  • Hemangioma* / complications
  • Hemangioma* / surgery
  • Humans
  • Male
  • Spinal Cord Diseases* / diagnostic imaging
  • Spinal Cord Diseases* / surgery
  • Spinal Neoplasms* / complications
  • Spinal Neoplasms* / diagnostic imaging
  • Spinal Neoplasms* / surgery
  • Spine
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / surgery
  • Treatment Outcome