Flourescein Angiography-assisted In Microsurgical Management Of Spinal Cord Vascular Tumors(4 Cases Report)

Background and Aim: Spinal cord vascular tumors are uncommonly,histologically benign,highly vascularized tumors.The study aims to summarize the clinical features,diagnosis and surgical techniques of 4 spinal cord vascular tumors.To explore the utility of intraoperative indocyanine green videoangiography in microsurgery of spinal cord vascular tumors. Methods: Clinical data of 3 patients with spinal cord hemangioblastomas and 1 patient with calillary hemangioma treated in our department over the past year were reviewed.3 tumors were in thoracic and 1 in the cervical spine.Posterior approach was performed.The entire surgical dissection was done under high magnification of the operating microscope. In the process of microsurgery, by taking indocyanine green angiography to identify the feeding arteries and draining veins. Cut off the feeding arteries,the tumor,and the draining veins in turn.And then,taking the indocyanine green angiography again,to evaluate operation resection and spinal cord in normal vessels. Mc Cormic scale and MRI was used to evaluate before and after operation. Results: Indocyanine green angiography was used in the process of microsurgery.Total resection was performed in 3 cases and partial resection in 1 case.Postoperative functional assessment showed that the motor deficits were improved,and the sensory deficits worsened in four cases.No operation-related mortality.Spinal cord syrinx was improved by MRI reviewed.All of the tumors were comfirmed as hemangioblastoma by the pathological diagnosis.During 6 to 24 months’ follow-up,no recurrence occurred.The neurological function was improved in different degrees. Conclusions: Intramedullary vascular tumors are rare,highly vascularized tumors.The initial symptom including numb,pain and weakness. Application of intraoperative indocyanine green videoangiography can clearly show the boundary of tumors,the feeding arteries,and the draining veins, which is necessary to ensure safe and precise resection of spinal intramedullary tumors.