Introduction: Two example case reports are presented of symptomatic vertebral haemangiomas. These were managed by percutaneous acrylic vertebroplasty in preference to total vertebrectomy and trivertebral fusion.

Subjects: Both patients were female and presented with severe thoracolumbar pain. One, aged 23, had an implosion fracture of L₂ with kyphosis. The other, aged 73, had continuous back pain made worse by lying down. MRI revealed haemangiomas in both cases replacing the vertebral bodies of L₂ and L₄ respectively. There was no neurological deficit.

Technique: Percutaneous vertebroplasty was performed in both cases under general anaesthetic by bilateral synchronous transpedicular injection of polymethyl-methacrylate, using continuous biplanar image intensifier control to monitor the distribution of the acrylic.

Results: Both cases were relieved of all symptoms from the moment of waking from the anaesthetic. The total number of haemangioma cases treated in Athens and Geneva is 11, and these current results are typical of the series¹ where all cases have been effectively treated without significant complications. Follow up one to seventy-two months.

Conclusion: Percutaneous acrylic vertebroplasty should be the treatment of choice for symptomatic vertebral haemangiomas without neurological involvement. The reason for this presentation is to emphasise not only the relative simplicity of the technique but also the impressive immediate resolution of symptoms.