OUR EXPERIENCE IN THE TREATMENT OF AGGRESSIVE SPINAL HEMANGIOMAS BY THE METHOD OF PERCUTANEOUS VERTEBROPLASTY

Oybek Sobirovich Allaberganov Republican Specialized Scientific and Practical Medical Center of Neurosurgery, Urgench branch of the Tashkent Medical Academy, Urgench, Uzbekistan
Ravshan Muslimovich Yuldashev Republican Specialized Scientific and Practical Medical Center of Neurosurgery Tashkent, Uzbekistan
Jasur Oltibayevich Sabirov Republican Specialized Scientific and Practical Medical Center of Neurosurgery Tashkent, Uzbekistan

Abstract

The experience of the operations performed during this time shows that filling the hemangioma with bone cement stops further tumor growth, reliably stabilizes the body of the affected vertebra and provides a clinical effect, which is manifested by regression of the pain syndrome. PVP can be performed both before and after radiation therapy. It does not exclude, but complements other methods of treating spinal hemangiomas. [3].Despite the great popularity of PVP method in various countries and the sufficient period of its application, the issues of choosing puncture accesses at different levels and with different localizations of hemangiomas in the vertebra, advisability of using bilateral accesses still remain deft, and how to calculate the amount of cement necessary for filling the body of the affected vertebrahas not been defined yet. In the Republican Scientific Center of Neurosurgery using the PVP method in 2016-2017, 32 patients (22 women and 10 men) aged from 21 to 69 years with aggressive spinal hemangiomas were operated on. All patients underwent a comprehensive examination, including spondylography, CT, MRI, MSCT. The indications for PVP were signs of aggressiveness of hemangiomas, progressive development of clinical and radiological symptoms, as well as MRI data. During the surgery, venous spondylographywas performed to visualize the venous outflow collectors. At the mid- and lower cervical level (CIII - CVII), the access of choice is anterolateral part. Based on large number of experimental works on the biomechanics of the spine and clinical material, it was found that to stabilize the vertebral body and relieve pain, introduction of 3 ml of bone cement is enough.[5, 10]. The maximum volume of bone cement in the treatment of aggressive spinal hemangiomas is determined according to the data of visual control using an intraoperative electron-optical image intensifier. Transpedicular puncture access is the access of choice in the treatment of aggressive hemangiomas of the spine by PVP, localized in the thoracic and lumbar regions, and anterolateral - with the localization of hemangioma in the cervical region.

Keywords:

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aggressive spinal hemangiomas, percutaneous vertebroplasty


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