The patient underwent a safe and successful posterior decompression with corpectomy and instrumented fusion with minimal blood loss and discharged home with reversal of neurologic deficits and resolution of symptoms. A and B) demonstrates selective PVA embolization with complete devascularization of the tumor on completed embolization. This was performed with 100-300 micron particles achieving an excellent devascularization (Figure 3. Superselective WADA testing was performed with Brevital injected through the microcatheter, which failed to elicit changes in the intraoperative monitoring, confirming safety to proceed with devascularization of this pedicle and tumor. No spinal artery contributions were found to arise from this right T1-T3 pedicle. (A, B) Selective angiography of the right supreme intercostal artery demonstrates extensive hypervascularity of this aggressive T3 hemangioma. Spinal angiography showed a very hypervascular lesion fed predominantly by the right supreme intercostal artery (Figure 2. Our neurosurgical team was consulted for preoperative embolization of the tumor prior to surgical decompression and instrumented fusion. A diagnosis of vertebral body hemangioma, an aggressive subtype, was made and spinal surgery consultation obtained. Significant spinal cord compression was identified with no other bony lesions in the entire spinal axis. (Dashed lines in A) tumor infiltration Dashed lines and Arrows in B) cord compression. ![]() B and C) Axial MRI images of T3 demonstrates extensive infiltrative lesion with extradural compression of the thoracic spinal cord. A) Sagittal T2 MRI demonstrates aggressive hyperintense T3 hemangioma involving the body and posterior elements compressing the thoracic spinal cord (arrows)įigure 1.
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