Minimally Invasive Resection of a Spinal Epidural Cavernous Hemangioma

Objective and ImportanceMinimally invasive techniques for spinal surgery are rapidly evolving. We present a rare case of a symptomatic spinal epidural cavernous hemangioma that was treated using minimally invasive surgical techniques. The pathophysiology, radiology, and histology of epidural cavernous hemangiomas are reviewed. The advantages and pitfalls of minimally invasive spinal surgery techniques are discussed.Clinical PresentationA 45 year-old woman presented with a four-year history of right leg weakness and difficulty with ambulation. MRI examination of the lumbar spine revealed an epidural mass.InterventionThe patient elected to undergo a minimally invasive, microendoscopic resection of the lesion. The MetRxTM (Medtronic, Memphis, TN) dilator system was employed to gain access to the L2 lamina. A hemilaminectomy and resection of the lesion was accomplished without complication.ConclusionSpinal epidural masses, in this case a cavernous hemangioma, can be safely and effectively treated with minimally invasive techniques. With decreased soft tissue injury, minimal blood loss, and shortened operative time, minimally invasive techniques should be considered when resecting epidural masses.