The Diagnosis And Treatment Strategy Of Symptomatic Vertebral Hemangiomas

Objective:To discuss the diagnosis and treatment strategy of the different parts and types of symptomatic vertebral Hemangiomas(SVH).Methods:Twenty six patients with SVH received treatment in our hospital from November,2004 to August,2010 were retrospectively reviewed.Patients were divided into conservative group and treatment group based on the locations and pathological types of SVH.In the conservative group,12 patients were affiliated with cavernous hemangioma as the MRI images demonstrated medium-high signal intensity on T1WI and high intensity on T2WI.The patients received physiotherapy and symptomatic treatment.In the treatment group,2 patients of cervical symptomatic vertebral hemangiomas as MRI images demonstrated medium-high signal intensity on T1WI and high intensity on T2WI.The patients received radiotherapy as there were a high risk for operation.MRI images showed low intensity on T1WI and high intensity on T2WI for the rest 12 patients,among whom 10 received vertebroplasty as they were affiliated with SVH of local pain,and 2 patients received surgery as they had nerve root irritation symptoms.VAS score was performed to determine the pain.Treatment efficiency was determined by post-operative pain relief ratio, which was indicated by pre-operative VAS score-post-operative VAS score/pre-operative VAS score.Student T test was used to detect the significance.Results:In group A,8-32 months follow-up were performed,pain relieved,and no significant imaging changes were detected.VAS score showed statistic difference,demonstrated the conservative treatment could improve the patients'symptoms significantly.In group B,3-63 months follow-up were performed.Post-operative pain or nerve root irritation symptoms reduced obviously with no complications among the patients.Statistic analysis showed significant difference between pre-operative and post-operative VAS scores.Complete pain relief was detected in 2 patients received radiotherapy after 2 years follow-up.Conclusions:According to different parts and different types of Symptomatic Vertebral Hemangiomas selected the appropriate treatment strategy could achieve a good therapeutic effect.MRI was the preferred method for the diagnosis of VH.