Effect of preoperative feeding artery occlusion on invasive vertebral hemangioma resection_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

FAN Hongguo ¹ , HAO Dingjun ² , GUO Yunshan ² , ZHANG Xinliang ² , GAO Wenjie ² , WANG Xiaodong ² ,  ZHU Jinwen ²

1. Department of Orthopedics, Guyuan Traditional Chinese Medicine Hospital, Guyuan Ningxia, 756000, P.R.China;
2. Department of Spine Surgery, Honghui Hospital Affiliated to Medical School of Xi’an Jiao Tong University, Xi’an Honghui Hospital, Xi’an Shaanxi, 710054, P.R.China;

Corresponding author：

ZHU Jinwen, Email: 903976421@qq.com

Keywords：

Invasive vertebral hemangioma; vertebral body resection; feeding artery

DOI：

10.7507/1002-1892.201811055

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Objective To evaluate the effectiveness and safety of preoperative feeding artery occlusion on vertebral resection of invasive vertebral hemangioma. Methods The clinical data of 20 patients with invasive vertebral hemangioma who received posterior lumbar vertebral body resection, bone grafting, fusion and internal fixation between March 2010 and March 2017 were retrospectively analyzed. According to whether feeding artery occlusion was performed before operation, the patients were divided into group A (11 cases, tumor feeding artery occlusion before operation) and group B (9 cases, no tumor feeding artery occlusion before operation). There was no significant difference in gender, age, lesion segment, and disease duration between the two groups (P>0.05). The operation time, intraoperative blood loss, postoperative drainage volume, blood transfusion volume, and ambulant time after surgery, hospitalization time, and deep venous thrombosis of lower extremities were recorded and compared between the two groups. Pain improvement was evaluated by visual analogue scale (VAS) score. Results The operation time, intraoperative blood loss, blood transfusion volume, and ambulant time after surgery were significantly less in group A than those in group B (P<0.05). There was no significant difference in postoperative drainage volume and hospitalization time between the two groups (P>0.05). Five patients (3 in group A and 2 in group B) suffered from pleural tear due to intraoperative pleural adhesions. Closed thoracic drainage tubes were placed immediately after suture and extubated on 3-5 days. Both groups were followed up 1-1.5 years, with an average of 1.35 years. In group B, 1 patient died of pulmonary embolism at 7 days after operation; and 2 patients developed deep venous thrombosis of lower extremity after operation, who were treated with inferior vena cava filter and thrombolytic therapy, and recovered well after operation. The local pain of the other patients was significantly relieved after operation, and the pain disappeared at 1 month after operation. The VAS scores of the two groups at 3 days after operation were significantly improved when compared with those before operation (P<0.05). There was no significant difference in VAS scores between the two groups before operation and at 3 days after operation (P>0.05). Three patients (2 in group A and 1 in group B) who had neurological symptoms were significantly relieved after surgery. Bone healing was achieved in both groups at 1 year after operation. No fracture or loosening of internal fixator occurred during follow-up. Conclusion Nutritional artery occlusion before vertebrectomy for invasive vertebral hemangioma can effectively reduce intraoperative blood loss, operation time, perioperative blood transfusion, and other perioperative complications.

Citation： FAN Hongguo, HAO Dingjun, GUO Yunshan, ZHANG Xinliang, GAO Wenjie, WANG Xiaodong, ZHU Jinwen. Effect of preoperative feeding artery occlusion on invasive vertebral hemangioma resection. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(5): 606-611. doi: 10.7507/1002-1892.201811055 Copy

1.	Arbajian E, Magnusson L, Brosjö O, et al. A benign vascular tumor with a new fusion gene: EWSR1-NFATC1 in hemangioma of the bone. Am J Surg Pathol, 2013, 37(4): 613-616.
2.	Cheung NK, Doorenbosch X, Christie JG. Rapid onset aggressive vertebral haemangioma. Childs Nerv Syst, 2011, 27(3): 469-472.
3.	Manning HJ. Symptomatic hemangioma of the spine. Radiology, 1951, 56(1): 58-65.
4.	杨强, 李建民, 杨志平, 等. 伴脊髓压迫的脊椎侵袭性血管瘤手术方式选择. 中国脊柱脊髓杂志, 2018, 28(3): 228-233.
5.	Jayakumar PN, Vasudev MK, Srikanth SG. Symptomatic vertebral haemangioma: endovascular treatment of 12 patients. Spinal Cord, 1997, 35(9): 624-628.
6.	Acosta FL Jr, Sanai N, Cloyd J, et al. Treatment of Enneking stage 3 aggressive vertebral hemangiomas with intralesional spondylectomy: report of 10 cases and review of the literature. J Spinal Disord Tech, 2011, 24(4): 268-275.
7.	Goldstein CL, Varga PP, Gokaslan ZL, et al. Spinal hemangiomas: results of surgical management for local recurrence and mortality in a multicenter study. Spine (Phila Pa 1976), 2015, 40(9): 656-664.
8.	Jiang L, Liu XG, Yuan HS, et al. Diagnosis and treatment of vertebral hemangiomas with neurologic deficit: a report of 29 cases and literature review. Spine J, 2014, 14(6): 944-954.
9.	Inoue T, Miyamoto K, Kodama H, et al. Total spondylectomy of a symptomatic hemangioma of the lumbar spine. J Clin Neurosci, 2007, 14(8): 806-809.
10.	丛海波, 张恩忠, 余志平, 等. 增强现实技术联合3-D打印技术行半椎体置换治疗椎体肿瘤一例. 中国修复重建外科杂志, 2017, 31(11): 1407-1408.
11.	孙兆忠, 程艳, 李瑞, 等. 经侧前方入路L₅椎体切除后腰骶部重建的影像学及生物力学研究. 中国修复重建外科杂志, 2017, 31(2): 210-214.
12.	Gross CE, Hodge CH Jr, Binet EF, et al. Relief of spinal block during embolization of a vertebral body hemangioma. Case report. J Neurosurg, 1976, 45(3): 327-330.
13.	Hekster RE, Luyendijk W, Tan TI. Spinal-cord compression caused by vertebral haemangioma relieved by percutaneous catheter embolisation. Neuroradiology, 1972, 3(3): 160-164.
14.	Raco A, Ciappetta P, Artico M, et al. Vertebral hemangiomas with cord compression: the role of embolization in five cases. Surg Neurol, 1990, 34(3): 164-168.
15.	Smith TP, Koci T, Mehringer CM, et al. Transarterial embolization of vertebral hemangioma. J Vasc Interv Radiol, 1993, 4(5): 681-685.

1. Arbajian E, Magnusson L, Brosjö O, et al. A benign vascular tumor with a new fusion gene: EWSR1-NFATC1 in hemangioma of the bone. Am J Surg Pathol, 2013, 37(4): 613-616.
2. Cheung NK, Doorenbosch X, Christie JG. Rapid onset aggressive vertebral haemangioma. Childs Nerv Syst, 2011, 27(3): 469-472.
3. Manning HJ. Symptomatic hemangioma of the spine. Radiology, 1951, 56(1): 58-65.
4. 杨强, 李建民, 杨志平, 等. 伴脊髓压迫的脊椎侵袭性血管瘤手术方式选择. 中国脊柱脊髓杂志, 2018, 28(3): 228-233.
5. Jayakumar PN, Vasudev MK, Srikanth SG. Symptomatic vertebral haemangioma: endovascular treatment of 12 patients. Spinal Cord, 1997, 35(9): 624-628.
6. Acosta FL Jr, Sanai N, Cloyd J, et al. Treatment of Enneking stage 3 aggressive vertebral hemangiomas with intralesional spondylectomy: report of 10 cases and review of the literature. J Spinal Disord Tech, 2011, 24(4): 268-275.
7. Goldstein CL, Varga PP, Gokaslan ZL, et al. Spinal hemangiomas: results of surgical management for local recurrence and mortality in a multicenter study. Spine (Phila Pa 1976), 2015, 40(9): 656-664.
8. Jiang L, Liu XG, Yuan HS, et al. Diagnosis and treatment of vertebral hemangiomas with neurologic deficit: a report of 29 cases and literature review. Spine J, 2014, 14(6): 944-954.
9. Inoue T, Miyamoto K, Kodama H, et al. Total spondylectomy of a symptomatic hemangioma of the lumbar spine. J Clin Neurosci, 2007, 14(8): 806-809.
10. 丛海波, 张恩忠, 余志平, 等. 增强现实技术联合3-D打印技术行半椎体置换治疗椎体肿瘤一例. 中国修复重建外科杂志, 2017, 31(11): 1407-1408.
11. 孙兆忠, 程艳, 李瑞, 等. 经侧前方入路L₅椎体切除后腰骶部重建的影像学及生物力学研究. 中国修复重建外科杂志, 2017, 31(2): 210-214.
12. Gross CE, Hodge CH Jr, Binet EF, et al. Relief of spinal block during embolization of a vertebral body hemangioma. Case report. J Neurosurg, 1976, 45(3): 327-330.
13. Hekster RE, Luyendijk W, Tan TI. Spinal-cord compression caused by vertebral haemangioma relieved by percutaneous catheter embolisation. Neuroradiology, 1972, 3(3): 160-164.
14. Raco A, Ciappetta P, Artico M, et al. Vertebral hemangiomas with cord compression: the role of embolization in five cases. Surg Neurol, 1990, 34(3): 164-168.
15. Smith TP, Koci T, Mehringer CM, et al. Transarterial embolization of vertebral hemangioma. J Vasc Interv Radiol, 1993, 4(5): 681-685.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of preoperative feeding artery occlusion on invasive vertebral hemangioma resection

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