Introduction: Spinal hemangioblastomas are highly vascular intramedullary tumors and should be removed en block after coagulation of feeding arteries. It is important to identify the difference between feeders and normal vessels. We retrospectively analysed the usefulness of intraoperartive ICG videoangiography for spinal hemangioblastomas.videoangiography for spinal hemangioblastomas.
Methods: Four spinal hemangioblastomas (2 in cervical associated with von Hippel-Lindau syndrome, 2 in thoracic) were performed hemilaminectomy in prone position, Both after opening dura and removal of tumor, ICG (5mg) was injected intravenously.
Results: The ICG angiography clearly demonstrated feeding and draining vessels and the location of intramedullary tumor. Moreover normal spinal cord vessels were indentified easily. Total removal of the tumors and preservation of normal blood supply of the spinal cord were performed safely in all cases. The cervical case associated with von Hippel-Lindau syndrome had temporary mild motor weakness of left hand and dysesthesia and improved 1 weeks after surgery.
Conclusions: Intraoperative ICG videoangiography for spinal hemangiblastomas was useful because of providing information not only difference from feeding arteries and normal spinal cord vessels but also the location of the tumors. Moreover this is a less invasive and easy technical method on the intraoperative diagnosis.
Patient Care: We can identify the feeding arteries and the location of spinal hemangioblastomas easily. So we will remove the tumors totally under no or minimum neurorlogical deficit.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of identification of the feeding arteries using ICG videoangiography 2) Discuss, in small groups, the technique of removal of spinal hemangiblastoma