Hemangiomul vertebral reprezintă o tumoare vasculară care evoluează, în majoritatea cazurilor, asimptomatic şi cel mai des se depistează ocazional. Mult mai rar, hemangiomul are o evoluţie agresivă, cauzând simptome neurologice care necesită un tratament chirurgical. Vertebroplastia percutană ocupă un loc important în şirul măsurilor terapeutice disponibile. În acest context, prezentăm un caz de hemangiom agresiv de corp vertebral L3 responsabil de lombalgie severă de mai mulţi ani. Pacientul a fost supus procedurii de vertebroplastie cu un rezultat clinic excelent. În acest articol prezentăm diferite tehnici pentru vertebroplastie, avantajul lor faţă de alte metode de tratament conservativ sau chirurgical, dar şi complicaţiile acesteia.

Vertebral hemangiomas (VHs) are common benign vascular lesions of the spine found in ~ 11% of patients at autopsy. Approximately two-thirds are solitary and about one-third are multiple. The majority (about 60%) are found in the thoracic region. Most VHs are asymptomatic and only come to attention when discovered incidentally during a radiologic examination. Rarely, VHs become painful either with or without an associated compression fracture. Some exhibit aggressive characteristics such as expansion of the contours of the vertebral body and extension of tumor outside the vertebrae and into the epidural space. Either of these features may produce nerve root impingement or spinal cord compression. Cement injection in these cases may be performed for pain relief, strengthening of the bone, and devascularization of the hemangioma. Early diagnosis and treatment of symptomatic vertebral hemangiomas is essential to prevent permanent and irreversible neurologic defi cit.

Вертебральные гемангиомы являются доброкачественными сосудистыми опухолями тела позвонка. Две трети поражают один позвонок, он в трети случаев являются множественными. В большинстве случаев гемангиомы протекают бессимптомно и обнаруживаются случайно при радиологических исследованиях. В некоторых случаях, однако, гемангиомы проявляют себя болевым синдромом или компрессионными переломами. Введение цемента в тело позвонка посредством пункционной вертебропластики в таких случаях может привести к уменьшению болей, усилению структуры тела позвонка и деваскуляризации гемангиомы.