2024-03-29T10:13:46Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:02001666
2023-11-16T01:56:48Z
499:508:509:1638493189962
Piecemeal resection of aggressive vertebral hemangioma using real-time navigation-guided drilling technique
Nagashima, Yoshitaka
Nishimura, Yusuke
Haimoto, Shoichi
Eguchi, Kaoru
Awaya, Takayuki
Ando, Ryo
Akahori, Sho
Hara, Masahito
Natsume, Atsushi
open access
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
aggressive vertebral hemangioma
CT navigation system
preoperative arterial embolization
piecemeal total resection
navigation-guided drill
Vertebral hemangiomas are the most common benign vertebral tumors and are usually asymptomatic. Aggressive subtypes of the tumor, called aggressive VHs (AVHs), can become symptomatic with extraosseous extensions and require surgical removal. We present a case of AVH in a 36-year-old man presenting with low back pain and right leg pain that persisted for three months. Imaging studies showed a Th12 vertebral tumor that extended into the spinal canal and was squeezing the spinal cord. Computed tomography (CT)-guided biopsy indicated vertebral hemangimoa. Following preoperative arterial embolization, piecemeal gross total resection was attained under navigation guidance. He was left with no neurological deficit and remained well at the 12-month postoperative folow-up. Since AVHs are benign tumor, piecemeal removal of the tumor can be selected. However, disadvantage of the approach include difficulty of making decision how much to remove the front part of the vertebral body close to thoracic descending aorta. Furthermore, when the tumor tissue is too hard to curett, manipulation in tight spaces near the spinal cord carries the risk of damaging it. Navigation-guided drill is highly helpful for real-time monitoring of ongoing tumor resection. It enables safely resection of the tumor especially in the anterior cortical surface of the vertebral body and easily resection even hard tumors. This method results in reducing residual tumor and maintaining safety resection.
Nagoya University Graduate School of Medicine, School of Medicine
2021-11
eng
departmental bulletin paper
VoR
https://doi.org/10.18999/nagjms.83.4.861
http://hdl.handle.net/2237/0002001666
https://nagoya.repo.nii.ac.jp/records/2001666
10.18999/nagjms.83.4.861
https://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/834.html
0027-7622
2186-3326
Nagoya Journal of Medical Science
83
4
861
868
https://nagoya.repo.nii.ac.jp/record/2001666/files/18_Nagashima.pdf
application/pdf
21.4 MB
2021-12-03