Thematic review and illustrative videos of aggressive vertebral column hemangioma management: illustrative cases
Year: 2025
Type: article
Abstract: BACKGROUND: Aggressive vertebral hemangiomas (AVHs) are benign vascular lesions that can exhibit locally invasive behavior. Because of their rarity, standardized treatment guidelines are lacking. We present 2 surgically managed cases, supplemented with intraoperative video, and conduct a thematic literature review evaluating treatment strategies. OBSERVATIONS: A 66-year-old female presented with low back pain radiating to the groin and gait instability. MRI demonstrated an L1 AVH. She underwent T12-L2 laminectomy, instrumented stabilization, and cement augmentation, followed by radiotherapy. Marked pain relief and functional improvement were reported. The second patient, a 14-year-old male, presented to his pediatrician with neck pain, hand weakness, and paresthesias. He sustained a fall at school and was brought to the emergency department with quadriparesis. Imaging revealed a C4-6 AVH with a C5 pathological fracture. Emergency C4-6 corpectomy, laminectomy, and posterior fixation were performed. Proximal upper extremity function partially recovered, but hand and lower extremity motor deficits persisted. A literature review demonstrated the importance of surgery and highlighted the roles of radiotherapy, cement augmentation, embolization, and alcohol-based injections in nonoperative and multimodal management. LESSONS: AVH management should be tailored based on location, extent of neural compression, and symptom severity. Surgical intervention remains central in cases with neurological compromise or instability. https://thejns.org/doi/10.3171/CASE25654.
DOI: 10.3171/case25654
Authors: Hughes W. Benjamin, Lauren E. Corliss, Michael A. Galgano
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Suzhou Gusu Medical Youth Talent, Kornerup Fonden, United States Agency for International Development, Dagmar Marshalls Fond, Kræftens Bekæmpelse, Rune och Ulla Amlövs Stiftelse för Neurologisk och Reumatologisk Forskning, University of Texas at Austin, University of Bern, Wellcome Trust, Seattle Genetics, Petrus och Augusta Hedlunds Stiftelse, Key Laboratory in Science and Technology Development Project of Suzhou, Jiangsu Commission of Health, Agence Régionale de Santé Martinique, Multiple Sclerosis Society, European Commission, National Research Foundation, Deutsche Forschungsgemeinschaft, Institut National de la Santé et de la Recherche Médicale, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, National Natural Science Foundation of China, Grantová Agentura České Republiky, ZonMw, Austrian Science Fund, Bundesministerium für Gesundheit, National Research Foundation of Korea, IngaBritt och Arne Lundbergs Forskningsstiftelse, Jane ja Aatos Erkon Säätiö, King Abdullah University of Science and Technology, Vetenskapsrådet, Natural Science Foundation of Jiangsu Province, José Carreras Leukämie-Stiftung, Russian Science Foundation, Agence Française de Sécurité Sanitaire de l'Environnement et du Travail, Svenska Läkaresällskapet, University of Tabriz, Reumatikerförbundet, National Institute of Fisheries Science, Emil och Wera Cornells Stiftelse, Else og Mogens Wedell Wedellsborgs Fond, Fabrikant Einar Willumsens Mindelegat, Grosserer M. Brogaard og Hustrus Mindefond, Korea Institute of Marine Science and Technology promotion, Scheme for Promotion of Academic and Research Collaboration, Tiina ja Antti Herlinin säätiö, Health Commission of Sichuan Province, National Institutes of Health, College of Veterinary Medicine, University of Georgia, Natural Sciences and Engineering Research Council of Canada, Social Sciences and Humanities Research Council of Canada, Health Technology Assessment Programme, Japan Society for the Promotion of Science, Japan Science and Technology Agency, Agencia Nacional de Promoción Científica y Tecnológica, Faculty of Medicine, Chiang Mai University, National Key Research and Development Program of China, Fundamental Research Funds for the Central Universities, Humanities and Social Science Fund of Ministry of Education of China, Division of Research Capacity Development, Natural Science Basic Research Program of Shaanxi Province, National Institute on Aging, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, Ramsay Hospital Research Foundation, Degrees Initiative
OpenAlex ID: W7114891808
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