Purpose

The purpose of this study is to evaluate the role of spinal angiography and arterial embolization in avoiding spinal cord ischemia in patients undergoing CT-guided alcohol injection of aggressive vertebral hemangiomas.

Methods

In this retrospective study, patients with vertebral hemangioma who underwent CT-guided direct alcohol injection between January 2007 and October 2018 were identified. Of 28 such patients, 26 had neurological deficits, and 2 had only back pain or radiculopathy. Direct alcohol injection without prior arterial embolization was done in 17 patients. Direct alcohol injection with prior arterial embolization was done in 11 patients. Clinical outcome was assessed immediately after the intervention and at follow-up.

Results

Three patients, who underwent alcohol injection without trans-arterial embolization, had worsening of neurological deficits in the post procedure period due to spinal cord ischemia. No complications related to spinal cord ischemia were noted in the embolization group. There was no significant difference in the outcomes between the two groups if the three patients with complications are excluded (p = 0.34).

Conclusion

While CT-guided direct alcohol injection is effective in the management of symptomatic and aggressive vertebral hemangiomas, spinal angiography and trans-arterial embolization of the blood supply to the vertebral body hemangioma, prior to the direct transpedicular alcohol embolization of the lesion, improves the safety of the procedure.

中文翻译：

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脊髓血管造影和动脉栓塞术在 CT 引导下酒精注射侵袭性椎体血管瘤患者中的应用

目的

本研究的目的是评估脊髓血管造影和动脉栓塞术在避免在 CT 引导下酒精注射侵袭性椎体血管瘤的患者中避免脊髓缺血的作用。

方法

在这项回顾性研究中，确定了 2007 年 1 月至 2018 年 10 月期间接受 CT 引导下直接注射酒精的椎体血管瘤患者。在 28 名这样的患者中，26 名有神经功能缺损，2 名仅有背痛或神经根病。17 名患者进行了未经事先动脉栓塞的直接酒精注射。在 11 名患者中进行了直接酒精注射并预先进行了动脉栓塞。在干预和随访后立即评估临床结果。

结果

三名接受酒精注射但未进行动脉栓塞的患者在术后期间由于脊髓缺血而出现神经功能缺损恶化。栓塞组未发现与脊髓缺血相关的并发症。如果排除三名并发症患者，两组之间的结果没有显着差异（p  = 0.34）。

结论

虽然 CT 引导的直接酒精注射在治疗有症状和侵袭性椎体血管瘤方面是有效的，但在直接经椎弓根酒精栓塞病变之前，脊髓血管造影和经动脉栓塞椎体血管瘤的血液供应提高了安全性的程序。