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Open Access 15-03-2024 | Silicone | Ideas and Technical Innovations

Preoperative elastoplasty of aggressive vertebral hemangiomas in elderly patients: a new strategy for reducing intraoperative bleeding and complications

Authors: Giorgio Lofrese, Francesco Cultrera, Luca Ricciardi, Jacopo Visani, Luigino Tosatto, Maria Ruggiero, Nicolò Haznedari, Federico Menetti

Published in: European Spine Journal

Abstract

Purpose

Preoperative elastoplasty could be an alternative strategy for treating aggressive vertebral hemangiomas (VHs) in frail patients needing for spinal cord decompression, combining the advantages of embolization and vertebroplasty.

Methods

Three elderly patients with spinal cord compression from thoracic aggressive VHs underwent XperCT-guided percutaneous injection of silicone (VK100), filling the whole affected vertebra, followed by a decompressive laminectomy. At 12-months follow-up no recurrences, vertebral collapse or segmental kyphosis were noted at the CT scans, with patients reporting an improvement of preoperative neurological deficits, VAS and Smiley-Webster pain scale (SWPS) parameters.

Results

With its elastic modulus, non-exothermic hardening, and lower viscosity than PMMA, VK100 allowed a preoperative augmentation of the affected vertebral body, pedicles, and laminae without complications, with a controlled silicone delivery even in part of VH’s epidural components thanks to XperCT-guidance.

Conclusion

When facing highly bony erosive VH encroaching the spinal canal, VK100 combines the advantages of embolization and vertebroplasty especially in elderly patients, permeating the whole VH’s angioarchitecture, significantly reducing tumor.

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Title: Preoperative elastoplasty of aggressive vertebral hemangiomas in elderly patients: a new strategy for reducing intraoperative bleeding and complications
Authors: Giorgio Lofrese
Francesco Cultrera
Luca Ricciardi
Jacopo Visani
Luigino Tosatto
Maria Ruggiero
Nicolò Haznedari
Federico Menetti
Publication date: 15-03-2024
Publisher: Springer Berlin Heidelberg
Keywords: Silicone
Hemangioma
Hemangioma
Hemangioma
Hemangioma
Hemangioma
Laminectomy
Published in: European Spine Journal
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-024-08201-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Preoperative elastoplasty of aggressive vertebral hemangiomas in elderly patients: a new strategy for reducing intraoperative bleeding and complications

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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