7-YEAR FOLLOW-UP OF VERTEBRAL EXCISION AND RECONSTRUCTION FOR MALIGNANT HEMANGIOENDOTHELIOMA OF BONE

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.