ABSTRACT

In this study, a 69-year-old woman with more than one vertebral hemangioma causing spinal cord compression at different levels is presented. Posterior surgery was applied due to T12 vertebral compression fractures, and after five asymptomatic years, lower back pain, progressive strength loss in the lower extremities and difficulty in walking occurred for four months, and urinary and fecal incontinence occurred for four weeks. Multiple thoracic and lumbar vertebral hemangiomas were observed in thoracic and lumbar magnetic resonance imaging (MRI). T10 and L4 extraossous extension of the hemangiomas was causing cord compression. Selective embolization was performed preoperatively and in the presence of cord neuromonitorization, and cord decompression was achieved with anterior T10 corpectomy and L4 PVCR (posterior vertebral column resection) with an 18-month interval. Postoperative radiotherapy was performed. The patient’s neurological condition improved rapidly after surgery, and she was neurologically intact and able to walk independently. Vertebral hemangiomas can cause serious and progressive cord compression. If the principles of multidisciplinary treatment are applied accurately, this can be treated safely with surgery.