Abstract：
Vertebral hemangiomas (VHs) are relatively common, symptomatic benign tumors of the spine with a reported estimated incidence up to 11%. They usually appear in the body of the vertebrae; however, they can extend into pedicles, laminae, and epidural space. They may cause pain, neurologic deficits. and fractures.
In this retrospective, single-center study, we reviewed our cases with VH and we propose the novel classification system that evaluates these lesions per their views on magnetic resonance imaging and clinical findings under 4 main categories.
Our novel classification system proposes that grade I lesions occupy less than 50% of the vertebral body, whereas grade II lesions occupy more than 50% and grade III lesions occupy the whole corpus. Grade IV lesions show an epidural and pedicular extension. We propose that grade I lesions may not be worthwhile for follow-up, whereas asymptomatic grade II (a) lesions to be worthy for a biannual imaging and symptomatic thoracolumbar grade II (b) and thoracolumbar grade III lesions to be considered for percutaneous vertebroplasty. We imply that decompression, posterior spinal instrumentation, and open vertebroplasty may be performed for thoracolumbar grade IV lesions. We further consider cervical grade IIb, III, and grade IV lesions as operable because of the disadvantages of percutaneous vertebroplasty.
We suggest that our novel classification system may be useful for the determination of diagnostic and therapeutic procedures in the management of VH. Further multicentric trials on larger series are warranted to validate this system and popularize its utility in larger populations.
In this retrospective, single-center study, we reviewed our cases with VH and we propose the novel classification system that evaluates these lesions per their views on magnetic resonance imaging and clinical findings under 4 main categories.
Our novel classification system proposes that grade I lesions occupy less than 50% of the vertebral body, whereas grade II lesions occupy more than 50% and grade III lesions occupy the whole corpus. Grade IV lesions show an epidural and pedicular extension. We propose that grade I lesions may not be worthwhile for follow-up, whereas asymptomatic grade II (a) lesions to be worthy for a biannual imaging and symptomatic thoracolumbar grade II (b) and thoracolumbar grade III lesions to be considered for percutaneous vertebroplasty. We imply that decompression, posterior spinal instrumentation, and open vertebroplasty may be performed for thoracolumbar grade IV lesions. We further consider cervical grade IIb, III, and grade IV lesions as operable because of the disadvantages of percutaneous vertebroplasty.
We suggest that our novel classification system may be useful for the determination of diagnostic and therapeutic procedures in the management of VH. Further multicentric trials on larger series are warranted to validate this system and popularize its utility in larger populations.
摘要：
目的：椎体血管瘤（VHs）比较常见，有症状的脊柱良性肿瘤，据报道估计发病率高达11%。它们通常出现在椎骨体内；然而，它们可以延伸到椎弓根，薄片，和硬膜外腔。它们可能会引起疼痛，神经缺陷.和骨折。
方法：在本回顾性研究中，单中心研究,我们回顾了我们的VH病例,我们提出了一种新的分类系统,根据这些病变对磁共振成像的看法和4个主要类别下的临床发现来评估这些病变.
结果：我们新颖的分类系统提出，I级病变占椎体的50％以下，而II级病变占50％以上，III级病变占整个主体。IV级病变显示硬膜外和椎弓根延伸。我们认为I级病变可能不值得随访，而无症状的II级（a）病变值得进行两年一次的影像学检查，有症状的胸腰椎II级（b）和胸腰椎III级病变应考虑经皮椎体成形术。我们暗示减压，后路脊柱器械,对于胸腰椎IV级病变，可进行开放式椎体成形术。我们进一步考虑子宫颈等级IIb，III,由于经皮椎体成形术的缺点，IV级病变可手术。
结论：我们建议我们的新型分类系统可用于确定VH管理中的诊断和治疗程序。需要在更大的系列上进行进一步的多中心试验，以验证该系统并在更大的人群中推广其实用性。
方法：在本回顾性研究中，单中心研究,我们回顾了我们的VH病例,我们提出了一种新的分类系统,根据这些病变对磁共振成像的看法和4个主要类别下的临床发现来评估这些病变.
结果：我们新颖的分类系统提出，I级病变占椎体的50％以下，而II级病变占50％以上，III级病变占整个主体。IV级病变显示硬膜外和椎弓根延伸。我们认为I级病变可能不值得随访，而无症状的II级（a）病变值得进行两年一次的影像学检查，有症状的胸腰椎II级（b）和胸腰椎III级病变应考虑经皮椎体成形术。我们暗示减压，后路脊柱器械,对于胸腰椎IV级病变，可进行开放式椎体成形术。我们进一步考虑子宫颈等级IIb，III,由于经皮椎体成形术的缺点，IV级病变可手术。
结论：我们建议我们的新型分类系统可用于确定VH管理中的诊断和治疗程序。需要在更大的系列上进行进一步的多中心试验，以验证该系统并在更大的人群中推广其实用性。
