Dr. Sybert et al., 7-YEAR FOLLOW-UP OF VERTEBRAL EXCISION AND RECONSTRUCTION FOR MALIGNANT HEMANGIOENDOTHELIOMA OF BONE, Spine (Philadelphia, Pa. 1976), 20(7), 1995, pp. 841-844
Study Design. This study reports the 7-year follow-up of an L5 vertebr
al hemangioendothelioma treated with tumor excision and allograft reco
nstruction stabilized with transpedicular fixation. Objectives. A revi
ew of vertebral hemangioendotheliomas is provided to outline the ratio
nale for surgical excision in such cases. Summary of Background Data.
Radiation therapy has been the mainstay of therapy in surgically inacc
essible lesions of the spine. The long-term follow-up of radical spina
l tumor excision and reconstruction in previously surgically inaccessi
ble areas has not been reported for vertebral hemangioendothelioma. Me
thods. After embolizations, anterior L5 corpectomy and allograft femor
al reconstruction was performed. Second-stage (same day) posterior ele
ment excision was followed by VSP stabilization of L4-S1 with artifici
al pedicles anchored into the femoral allograft at L5. Radiation thera
py followed. Results. Satisfactory long-term (7-year) segmental recons
truction using allograft and VSP was realized, even in the face of pos
toperative radiation therapy.Conclusion. Contemporary spinal reconstru
ctive techniques have been developed that continue to limit the number
of surgically inaccessible tumors in the spine. The present report sh
ows these techniques to be durable and apparently effective in vertebr
al hemangioendothelioma.