Diａgnosis and surgical management of single intraspinal cavernous hemangioma

English Keywords:Cavernous hemangioma  Intraspinal  Dignosis  Surgical treatment

English Abstract:

  【Abstract】 Objective：To investigate the diagnosis and surgical management of single intraspinal cavernous hemangioma（CH）.Method：From January 2002 to November 2010，18 patients with single intraspinal CH determined pathologically and undergoing surgery were reviewed retrospectively.The function of the spinal cord was evaluated before and after surgery by using the Aminoff-Logue scale.Result：All 18 patients presented with preoperative neurological deficit.All underwent preoperative MRI，and six cases have typical imaging manifestation，which were consistent with pathological diagnosis.17 cases had single defect；while 1 case had multiple defects（L2，L3，and S1）；10 cases had 2 or 3 vertebrae involved.Posterior midline approach was performed in all cases.All patients were scheduled for surgery（within 1 week after determination） except for 3 cases at acute onset.17 patients with solitary lesion underwent total tumor resection，while 1 case only resected the tumor of L2-L3 that caused clinical symptoms and didn′t resect S1 that has no symptom.No surgery-associated complication occurred during the operation.The operation time was 170±20min，and the blood loss was 280±40ml.Cavernous hemangioma was determined pathologically in all patients.The preoperative Aminoff-Logue score was 3 to 11，with the average score of 6.0±2.8，while the postoperative one was 0 to 11，with the average score of 4.2±3.8，which showed significant difference（P＜0.05）.12 patients had spinal cord function improved，4 unchanged，and 2 deteriorated.No surgery related death was noted.All patients were followed up from 2 months to 5 years，averaging 30 months.8 patients followed up by out-patient had no recurrence of tumor，while of the rest 10 patients followed up by telephone，7 had symptoms improved，and 3 remained unchanged.Conclusion：When the patients have the typical MRI manifestation of the intraspinal cavernous hemangioma, MRI has diagnosis value. Patients with definite neurological symptoms should actively and early undergo tumor resection, and can obtain good operation result.