Surgical treatment of aggressive hemangiomas of the transitional cervical-thoracic spine in children (сlinical observations, preliminary results)

Abstract

Introduction. Vertebral hemangioma is a common pathology, in which 3.7% cases are aggressive. One of the pathogenetic factors contributing to the growth of vertebral hemangioma is mechanical overload. The transitional parts of the spine are the most loaded. Lesions of the transitional cervical-thoracic spine by hemangioma are rare (2%–4% of all vertebral hemangiomas). A common treatment for aggressive hemangiomas is puncture vertebroplasty. Currently, the number of pediatric patients with vertebral hemangiomas has increased, with an incidence close to 8% for individuals aged below 18 years. Exaggeration of the possibilities of conservative treatment for hemangiomas in children often leads to unsatisfactory results. Clinical research on this problem is relevant due to the lack information about the surgical tactics in aggressive spinal hemangiomas in children. Clinical observation. Two patients aged 15 and 17 years old with aggressive hemangiomas of the transitional cervical-thoracic spine underwent operation with the use of open-puncture vertebroplasty. There were no postoperative complications, and good preliminary results were obtained. Discussion. Various approaches in the treatment of aggressive hemangiomas of the transitional cervical-thoracic spine in children, including open-puncture vertebroplasty, were presented and analyzed. Conclusion. Due to the limited information about surgical treatment for pediatric vertebral hemangiomas, the presented clinical cases of surgical treatment for aggressive hemangiomas of the transitional cervical-thoracic spine may be of interest to a wide audience.