[Vertebral hemangioma with neurologic signs. Therapeutic results. Survey of the French Society of Neurosurgery].

45 cases of vertebral hemangiomas with neurologic involvement are reported. This series corresponds to the french experience between 1969 to 1988 (series of the "Société Française de Neuro-Chirurgie" (S.F.N.)). In this report, the therapeutic results are detailed. 16 patients were treated by a simple laminectomy, 6 by laminectomy associated with radiotherapy, 4 by radiotherapy alone. In 9 patients, a large removal of the hemangioma was performed by mean of a lamino-arthrectomy (7 cases) or a corporectomy (2 cases). 7 patients were treated by embolization or vertebroplasty. Both techniques were used alone or in association with surgery or radiotherapy. 3 patients had no therapy. Results of the S.F.N. series demonstrated that 75.5% of the patients had a long term favorable clinical course. 13.4% of the patients were not improved. Mortality was of 11.1%. The mean follow up time was of 51.6 months. Recurrence was encountered in 13 cases. It was mainly observed in the first two years. In cases of total involvement of the vertebrae by hemangioma, laminectomy associated with radiotherapy was the best mean of therapy: 93% of recovery without recurrence. Treatment of body localization appeared to be difficult. Corporectomy could be unefficient if a complete removal of the hemangioma could not be performed. In contrast, posterior arch localization was successfully treated by a simple laminectomy without radiotherapy, even in cases of incomplete removal of the hemangioma: all such cases (10 cases) had a complete recovery without recurrence.