1. 2020;23;E637-E642Single Level Percutaneous Vertebroplasty for Vertebral Hemangiomata — A Review of Outcomes
   Retrospective Study
   Mithun Nambiar, MBBS, Julian T. Maingard, MBBS, James R. Onggo, MBBS, Kevin Phan, MD, Hamed Asadi, MD, PhD, Duncan Mark Brooks, MBBS, Joshua A. Hirsch, MD, Ronil V. Chandra, MBBS, and Giovanni Anselmetti, MD.

BACKGROUND: Percutaneous vertebroplasty is a minimally invasive technique to treat patients with symptomatic vertebral hermangiomata.

OBJECTIVES: We present a single-operator series of cases to demonstrate the clinical outcomes and complication profiles for this technique.

STUDY DESIGN: This is a retrospective multi-center cohort study.

SETTING: Procedures were performed across multiple hospitals in Italy by a single proceduralist.

METHODS: All patients with symptomatic vertebral hermangiomata that had percutaneous vertebroplasty over a 14-year period (March 1999 to April 2013) by a single proceduralist were included in this study. Information collected included demographic data, vertebral level of intervention, cement volume used, and the Visual Analogue Score for pain that was assessed pre- and post-intervention. Patients were followed up for a minimum of one year.

RESULTS: Percutaneous vertebroplasty was performed for 50 patients. All patients had an improvement in pain, with 39 patients (78%) reporting complete pain relief. A unipedicular approach was undertaken in 41 cases (82%), and bipedicular approach in 8 patients (16%), while a transoral approach was used in one patient. The mean cement volume per vertebral level was 6.8 mL (1 – 18 mL). Recurrent symptoms occurred in 2 patients (4%) requiring repeat vertebroplasty. There were no cases of symptomatic cement leak, and no cases of procedural morbidity or mortality.

LIMITATIONS: As a multicenter study conducted over a 14-year time period, there may be heterogeneity in procedural technique and rehabilitation protocols. There were no cases of cement leakage in our study, which could be an underreporting of cases. This is could be due to none of our patients receiving a post procedural computerized tomography scan, which is more sensitive in detecting cement leakage when compared to procedural fluoroscopy.

CONCLUSION: Percutaneous vertebroplasty is associated with good post-procedural outcomes in patients with vertebral hermangiomata. Complications such as neurological injury and cement leakages are rare.

KEY WORDS: Hemangioma, interventional, radiology, spine, vertebroplasty