Symptomatic and aggressive vertebral hemangiomas in children: features of modern interpretation and treatment tactics
https://doi.org/10.14531/ss2024.63-72
Abstract
Objective. To analyze the features of clinical-radiological manifestations of symptomatic vertebral hemangiomas in children and the possibility of algorithmizing their treatment.
Material and Methods. As part of a monocenter cohort, 24 children aged 4 to 17 years received treatment for symptomatic vertebral hemangiomas. The clinical-radiological manifestations of the tumor and the effectiveness of various methods of invasive treatment were evaluated.
Results. Symptomatic uncomplicated and complicated vertebral hemangiomas, corresponding to stages S2 and S3 of the Enneking classification for benign tumors, occur in children with almost equal frequency. For tumors without extravertebral spread, a closed percutaneous vertebroplasty provides stable relief of complaints. For aggressive hemangiomas with extravertebral, including epidural, spread, various treatment methods are used. An algorithm for choosing therapeutic tactics is proposed.
Conclusion. Surgical treatment of symptomatic vertebral hemangiomas should be carried out using a tactical algorithm that takes into account the stage of the tumor (S2 or S3) and the possibility of performing closed or open vertebroplasty, selective arterial embolization and decompression and stabilization operations on the spine.
About the Authors
D. B. Malamashin
St. Petersburg Research Institute of Phthisiopulmonology
32 Politekhnicheskaya str., St. Petersburg, 194064, Russia
Russian Federation
Russian Federation
MD, PhD, orthopedic surgeon, senior researcher, Clinic of Pediatric Surgery and Orthopedics
A. Yu. Mushkin
St. Petersburg Research Institute of Phthisiopulmonology;
Pavlov First Saint Petersburg State Medical University
32 Politekhnicheskaya str., St. Petersburg, 194064, Russia;
6–8 L’va Tolstogo str., St. Petersburg, 197022, Russia
Russian Federation
Russian Federation
DMSc, Prof., chief researcher, Head of Clinic of Pediatric Surgery and Orthopedics, Head of the Scientific and Clinical Centre for Spinal Pathology;
Professor of the Department of traumatology and orthopedics
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Review
For citations:
Malamashin D.B., Mushkin A.Yu. Symptomatic and aggressive vertebral hemangiomas in children: features of modern interpretation and treatment tactics. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2024;21(1):63-72. https://doi.org/10.14531/ss2024.63-72
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