Percutaneous vertebroplasty with or without sclerotherapy for the treatment of symptomatic spinal haemangiomas: study of clinical safety and efficacy

Purpose : To illustrate safety and efficacy of percutaneous vertebroplasty (either solely performed or in combination to alcohol sclerotherapy) for treatment of symptomatic, aggressive vertebral haemangiomas in a series of consecutive patients. Material and Methods : Institutional database research from 1/1/2010 until 31/8/2020 identified 25 patients with 31 symptomatic, aggressive vertebral haemangiomas suffering from pain with or without neurologic compromise underwent percutaneous vertebroplasty either solely performed or in combination to alcohol sclerotherapy. When haemangioma was restrained to the vertebral body, percutaneous vertebroplasty was performed as the only treatment technique. When an epidural component was also present causing pressure effects upon the spinal sac, sclerotherapy was additionally performed with alcohol injection at the level of the vertebral pedicles. CT scan assessed implant distribution the morning post therapy and MRI was performed 6 months post. Numeric Visual pain scores (NVS) prior- and post-treatment were compared using Paired Samples t-Test and Wilcoxon Signed Rank Test. Results : Mean pain score prior to any therapy was 8.52 ± 1.388 NVS units. Mean pain score at 12 months post therapy was 1.68 ± 2.445 NVS units. There was a mean reduction of 6.84 ± 3.145 NVS units. The comparison of the patients’ self-reported outcomes concerning pain reduction and mobility improvement prior and post therapy was considered statistically significant (p<0.001). No complication was noted. Conclusions : Percutaneous vertebroplasty (either solely performed or in combination to alcohol sclerotherapy) seems to be a safe and efficient technique for the treatment of symptomatic, aggressive vertebral haemangiomas resulting in significant pain reduction and mobility improvement. Proper patient selection is a prerequisite for high success rate.