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Long run end result of therapy of vertebral physique hemangiomas with direct ethanol injection and quick section stabilization.

Long run end result of therapy of vertebral physique hemangiomas with direct ethanol injection and quick section stabilization.

Backbone J. 2018 Jun 08;:

Authors: Chandra PS, Singh P, Ok R, Agarwal D, Tandon V, Kale SS, Sarkar C

Summary
BACKGROUND: Vertebral physique (VH) hemangiomas with myelopathy are troublesome to handle.
OBJECTIVE: To guage the position of intra-operative ethanol embolization, surgical decompression and instrumented quick section fusion in VH with myelopathy and long-term end result (>24 months).
METHODS: Potential examine: Symptomatic VH with wire compression with myelopathy. Excluded: pathological fractures, and/or deformity or multi-level pathologies. Surgical procedure consisted of intra-operative bilateral pedicular absolute alcohol (<1% hydrated ethyl alcohol) injection, laminectomy and rope decompression on the stage of pathology adopted by a brief section instrumented fusion utilizing pedicle screws.
RESULTS: 33 sufferers (Imply 26.9 + 13.2, vary: 10-68 years, 18 females).
CLINICAL FEATURES: myelopathy all (5 paraplegic), sphincter involvement (13), and mid again/ decrease ache (7). Pre-operative American Spinal Damage Affiliation (ASIA) scores: A(7), B(11), C(6), D(eight) and E(1). Majority had single vertebral involvement (30), three a number of stage. Six underwent surgical procedure earlier (1 alcohol embolization right here). Imply surgical time: 124+39 minutes, common blood: 274+80 cc. Imply quantity of absolute alcohol injected: 14.6+5.7 cc. (2 requiring 20 & 25 cc). Rapid embolization achieved in all, permitting laminectomy and soft-tissue hemangioma removing simply. Put up-surgery, 1 affected person had transient deterioration, relaxation all sufferers improved (sphincters improved in 9) at a observe up ranging 28-103 months (imply 47.6+22.three). Comply with-up ASIA scores: E(26), D(four), B(2) & C(1). All sufferers confirmed proof of bone sclerosis and reduction of wire compression on follow-up imaging.
CONCLUSIONS: That is largest examine in literature exhibiting wonderful enchancment, low re-operation charges following ethanol embolization and quick section fixation.

PMID: 29890263 [PubMed – as supplied by publisher]

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