Research Information System
WORLD NEUROSURGERY, vol.184, no.3, pp.1-5, 2024 (SCI-Expanded)
OBJECTIVE: Vertebral hemangiomas (VHs) are relatively
common, symptomatic benign tumors of the spine with a
reported estimated incidence up to 11%. They usually
appear in the body of the vertebrae; however, they can
extend into pedicles, laminae, and epidural space. They
may cause pain, neurologic deficits. and fractures.
- METHODS: In this retrospective, single-center study, we
reviewed our cases with VH and we propose the novel
classification system that evaluates these lesions per their
views on magnetic resonance imaging and clinical findings under 4 main categories.
- RESULTS: Our novel classification system proposes that
grade I lesions occupy less than 50% of the vertebral body,
whereas grade II lesions occupy more than 50% and grade
III lesions occupy the whole corpus. Grade IV lesions show
an epidural and pedicular extension. We propose that
grade I lesions may not be worthwhile for follow-up,
whereas asymptomatic grade II (a) lesions to be worthy
for a biannual imaging and symptomatic thoracolumbar
grade II (b) and thoracolumbar grade III lesions to be
considered for percutaneous vertebroplasty. We imply that
decompression, posterior spinal instrumentation, and open
vertebroplasty may be performed for thoracolumbar grade
IV lesions. We further consider cervical grade IIb, III, and
grade IV lesions as operable because of the disadvantages
of percutaneous vertebroplasty.
- CONCLUSIONS: We suggest that our novel classification system may be useful for the determination of diagnostic and therapeutic procedures in the management of
VH. Further multicentric trials on larger series are
warranted to validate this system and popularize its utility
in larger populations.