CASE REPORT article
Front. Surg.
Sec. Neurosurgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1647623
Intravascular embolization with spinal decompression and vertebral shaping for acute cauda equina syndrome from aggressive vertebral hemangioma: A case report and literature review
Provisionally accepted
- Spinal Ward, The 900th Hospital of PLA Joint Logistic Support Force, Fuzong Clinical Medical College of Fujian Medical University, FuZhou, China
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Objective: To evaluate the clinical outcomes of a multidisciplinary approach for the treatment of aggressive vertebral hemangioma with acute cauda equina compression. Case description: A 37year-old female patient with aggressive vertebral hemangioma presented with sudden loss of muscle strength in both lower limbs (grade I-II) and difficulty in urination and defecation. Magnetic resonance imaging and digital subtraction angiography confirmed a vascular tumor within and around the L4 vertebra, causing cauda equina compression. The treatment involved staged vascular embolization (of the third lumbar artery and branches of the sacral artery) combined with L4 vertebroplasty, laminectomy decompression, and pedicle screw fixation. Postoperative pain was immediately relieved. After 3 months of rehabilitation, muscle strength in both lower limbs recovered to grade 3, with significant improvement in spontaneous urination and defecation. Imaging studies showed complete relief of spinal canal compression. Conclusions: Aggressive spinal hemangioma may require multidisciplinary collaboration, and staged vascular embolization combined with spinal decompression and stabilization surgery can effectively improve neurological function. Early intervention is crucial for achieving favorable outcomes.
Keywords: Aggressive vertebral hemangioma, Embolization therapeutic, Spinal Cord Compression, Vertebroplasty, multidisciplinary approach
Received: 23 Jun 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Chen, Wang, Wang, Chen, Xiao and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jie Xiao, Spinal Ward, The 900th Hospital of PLA Joint Logistic Support Force, Fuzong Clinical Medical College of Fujian Medical University, FuZhou, China
Xiu Yang, Spinal Ward, The 900th Hospital of PLA Joint Logistic Support Force, Fuzong Clinical Medical College of Fujian Medical University, FuZhou, China
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