Spinal hemangiomas: Results of surgical management for local recurrence and mortality in a multicenter study

Christina L. Goldstein, Peter Pal Varga, Ziya L. Gokaslan, Stefano Boriani, Alessandro Luzzati, Laurence Rhines, Charles G. Fisher, Dean Chou, Richard P. Williams, Mark B. Dekutoski, Nasir A. Quraishi, Chetan Bettegowda, Norio Kawahara, Michael G. Fehlings

Research output: Contribution to journalArticle

Abstract

Study Design. Multicenter, ambispective observational study. Objective. To quantify local recurrence and mortality rates after surgical treatment of symptomatic spinal hemangiomas and identify prognostic variables for local disease control. Summary of Background Data. Spinal hemangiomas are the most common primary tumors of the spine and are generally benign and usually asymptomatic. Because of the rarity of symptomatic spinal hemangiomas, optimal surgical treatment remains unclear. Methods. AOSpine Knowledge Forum Tumor Investigators created a multicenter database of primary spinal tumors including demographics, presentation, diagnosis, treatment, survival, and recurrence data. Tumors were classified according to Enneking and Weinstein-Boriani-Biagini. Descriptive statistics were summarized and time to mortality and recurrence was determined. Results. Between 1996 and 2012, 68 patients (mean age = 51 yr, SD = 16) underwent surgical treatment of a spinal hemangioma. Epidural disease was present in 55% of patients (n = 33). Pain and neurological compromise were presenting symptoms in 82% (n = 54) and 37% (n = 24) of patients, respectively. Preoperative embolization was performed in 35% of patients (n = 23), 10% (n = 7) had adjuvant radiotherapy, and 81% (n = 55) underwent posterior-alone surgery. The local recurrence rate was 3% (n = 2). Mortality secondary to spinal hemangioma was not observed (mean follow-up = 3.9 yr, SD = 3.8). Conclusion. This is the largest multicenter surgical cohort of spinal hemangiomas. Symptomatic spinal hemangiomas are a benign tumor despite frequently presenting with epidural disease and neurological compromise. Thus, formal en bloc resection is not required, and excellent rates of local control and long-term survival can result from aggressive intralesional resection during index surgery.

Original languageEnglish (US)
Pages (from-to)656-664
Number of pages9
JournalSpine
Volume40
Issue number9
DOIs
StatePublished - May 1 2015

Keywords

  • benign tumor
  • mortality rates
  • multicenter cohort
  • multicenter database
  • recurrence
  • spinal hemangioma
  • spinal tumor
  • surgical treatment
  • symptomatic spinal hemangiomas

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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  • Cite this

    Goldstein, C. L., Varga, P. P., Gokaslan, Z. L., Boriani, S., Luzzati, A., Rhines, L., Fisher, C. G., Chou, D., Williams, R. P., Dekutoski, M. B., Quraishi, N. A., Bettegowda, C., Kawahara, N., & Fehlings, M. G. (2015). Spinal hemangiomas: Results of surgical management for local recurrence and mortality in a multicenter study. Spine, 40(9), 656-664. https://doi.org/10.1097/BRS.0000000000000840