European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
-
To more safely resect pathological lesions during spinal vascular lesion surgery, it is most important to understand local abnormal hemodynamics in detail. New devices or techniques that make out intraoperative local hemodynamics have been awaited. To introduce a resourceful method, we present a case of spinal hemangioblastoma for which temporary arterial occlusion during near-infrared intraoperative indocyanine green (ICG) videoangiography gives useful assessment of the main and minor feeders easily. ⋯ Temporary clipping of the main feeders during intraoperative ICG videoangiography is very useful for easily determining the minor feeding arteries, and helpful for maintaining normal perfusion of the spinal cord in spinal hemangioblastoma surgery. Furthermore, the FLOW 800 analysis, especially the false color-coded variation, increased our understanding of the hemodynamics.
-
Spinal metastases are common in patients with cancer. Following lung and liver, spine is the most common site for cancers to metastasize. Many of them are hypervascularized. These cases are a particular challenge for the surgeon and represent a significant danger of massive blood loss during surgery. Hypervascularized metastases of the cervical spine also include the risk of postoperative bleeding with severe neurological impairment. We report a case of a 67-year-old women with breast cancer (BC) metastasis within the vertebral bodies of C3 and C4 with nearly complete bony destruction of the ventral column and intraspinal tumor masses compressing the spinal cord at level C3 and C4. The hypervascularized tumor was supplied by multiple minor vessels from both vertebral arteries, too small to be coiled individually. Due to an allergy to aspirin, intravascular stenting of the vertebral arteries was not an option. We decided to perform a preoperative direct injection of onyx-18 for embolization of the tumor. ⋯ Presurgical direct injection of Onyx-18 for treating hypervascular spinal metastases of breast cancer seems to be an effective and safe technique and reduces intraoperative bleeding to a minimum.
-
Case Reports
An acute abdominal syndrome reveals a postoperative ilio-iliac arteriovenous fistula: about one case.
Postoperative ilio-iliac arteriovenous fistula is an unusual but known complication after lumbar surgery. ⋯ Arteriovenous fistula is a possible etiology of acute abdominal syndrome in patients with lumbar or abdominopelvic surgery history.
-
Case Reports
Intractable hiccups caused by syringobulbia and syringomyelia associated with intramedullary spinal hemangioblastoma.
Hiccups caused by a neoplasm in the spinal cord are rare. ⋯ Intractable hiccups can be caused by syringobulbia associated with an intramedullary cord tumor in the cervical area and possible mechanisms of hiccups were reviewed.
-
Adamantinoma is a low-grade primary malignant bone tumour with slow growth and local recurrence. Its occurrence in the spine is extremely rare, particularly with multilevel involvement. This paper wants to present the first case involving a patient with recurrent thoracolumbar spinal adamantinoma, who underwent a successful three-level spondylectomy for en bloc resection. ⋯ This is the first case involving multilevel thoracolumbar spinal adamantinoma with repeated recurrence to be successfully treated by three-level TES by a single posterior approach.