Therapeutic cryotherapy guided by MRI and ultrasound for haemangiomas in erector muscles of the back

The indications, technique and results of cryotherapy for potentially hazardous paraspinal haemangiomas that would otherwise have to be treated surgically are described. Two men with back pain which limited work activity were treated by cryotherapy as an alternative to surgical therapy. Magnetic resonance imaging (MRI) was utilized for diagnosis and planning. Intraprocedural ultrasound was also utilized for guidance and monitoring. Techniques that were adapted from prostate cryotherapy with special probes are described. MRI proved crucial and essential for both diagnosis and planning. Laparoscopic ultrasound was also helpful. Both patients improved clinically and neither has required surgery with follow-up of over 1 year. No complications occurred. Image-guided cryotherapy, with at least 1 year follow-up, has been valuable to alleviate symptoms, avoid surgery, and permit patients to resume work.