医学
放射科
血管瘤
椎管
外科
栓塞
切除术
背痛
无症状的
脊髓
活检
精神科
病理
替代医学
作者
Yoshitaka Nagashima,Yusuke Nishimura,Shoichi Haimoto,Kaoru Eguchi,Takayuki Awaya,Ryo Ando,Sho Akahori,Masahito Hara,Atsushi Natsume
出处
期刊:PubMed
日期:2021-11-01
卷期号:83 (4): 861-868
被引量:3
标识
DOI:10.18999/nagjms.83.4.861
摘要
Vertebral hemangiomas are the most common benign vertebral tumors and are usually asymptomatic. Aggressive subtypes of the tumor, called aggressive VHs (AVHs), can become symptomatic with extraosseous extensions and require surgical removal. We present a case of AVH in a 36-year-old man presenting with low back pain and right leg pain that persisted for three months. Imaging studies showed a Th12 vertebral tumor that extended into the spinal canal and was squeezing the spinal cord. Computed tomography (CT)-guided biopsy indicated vertebral hemangimoa. Following preoperative arterial embolization, piecemeal gross total resection was attained under navigation guidance. He was left with no neurological deficit and remained well at the 12-month postoperative folow-up. Since AVHs are benign tumor, piecemeal removal of the tumor can be selected. However, disadvantage of the approach include difficulty of making decision how much to remove the front part of the vertebral body close to thoracic descending aorta. Furthermore, when the tumor tissue is too hard to curett, manipulation in tight spaces near the spinal cord carries the risk of damaging it. Navigation-guided drill is highly helpful for real-time monitoring of ongoing tumor resection. It enables safely resection of the tumor especially in the anterior cortical surface of the vertebral body and easily resection even hard tumors. This method results in reducing residual tumor and maintaining safety resection.
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