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- Title
Preoperative elastoplasty of aggressive vertebral hemangiomas in elderly patients: a new strategy for reducing intraoperative bleeding and complications.
- Authors
Lofrese, Giorgio; Cultrera, Francesco; Ricciardi, Luca; Visani, Jacopo; Tosatto, Luigino; Ruggiero, Maria; Haznedari, Nicolò; Menetti, Federico
- Abstract
Purpose: Preoperative elastoplasty could be an alternative strategy for treating aggressive vertebral hemangiomas (VHs) in frail patients needing for spinal cord decompression, combining the advantages of embolization and vertebroplasty. Methods: Three elderly patients with spinal cord compression from thoracic aggressive VHs underwent XperCT-guided percutaneous injection of silicone (VK100), filling the whole affected vertebra, followed by a decompressive laminectomy. At 12-months follow-up no recurrences, vertebral collapse or segmental kyphosis were noted at the CT scans, with patients reporting an improvement of preoperative neurological deficits, VAS and Smiley-Webster pain scale (SWPS) parameters. Results: With its elastic modulus, non-exothermic hardening, and lower viscosity than PMMA, VK100 allowed a preoperative augmentation of the affected vertebral body, pedicles, and laminae without complications, with a controlled silicone delivery even in part of VH's epidural components thanks to XperCT-guidance. Conclusion: When facing highly bony erosive VH encroaching the spinal canal, VK100 combines the advantages of embolization and vertebroplasty especially in elderly patients, permeating the whole VH's angioarchitecture, significantly reducing tumor.
- Subjects
OLDER patients; LAMINECTOMY; SURGICAL complications; VERTEBROPLASTY; SPINAL cord compression; HEMANGIOMAS; SPINAL canal
- Publication
European Spine Journal, 2024, Vol 33, Issue 5, p1921
- ISSN
0940-6719
- Publication type
Article
- DOI
10.1007/s00586-024-08201-0