Hemangioma of the vertebra: symptoms, diagnosis, treatment

Hemangioma is a local tumor-like proliferation of blood vessels. In fact, it is a benign tumor, i.e. It never metastasizes. According to modern data, every tenth inhabitant of the planet meets, but in 99% of cases it does not manifest itself at all and does not cause harm to health.

Most often there are surface forms, which are convex crimson formations on the skin. However, hemangioma can develop in any organ, and it can be detected only by chance, because It often occurs asymptomatically.

Hemangiomas are of two types: capillary and cavernous. The capillary form is a tangle of thin-walled vessels, and the cavernous form has the structure of several interconnected cavities. Capillary hemangioma grows very slowly and almost is not dangerous, while cavernous hemangioma often causes various complications. Establishing the shape of a tumor is important when deciding on treatment.

Among all the forms of the vertebral hemangioma (often called the vertebral column) is quite common. As a rule, it is found in pictures taken about osteochondrosis, radiculitis or other diseases of the spine. Usually the lower thoracic and upper lumbar vertebrae are affected. Neoplasm of small size does not manifest itself in any way and does not require special treatment. The tumor grows very slowly, however, when large sizes reach the hemangioma, the vertebra becomes a serious disease, often requiring surgical intervention.

What is dangerous hemangioma? First of all, as the tumor grows, it compresses the bone tissue of the vertebral body. It will be a constant pain in the back. If you do not take any measures, then with further growth, a vertebral fracture may occur. The likelihood of this becomes very high if the tumor occupies more than 50% of the volume of the vertebral body. Fractures usually occur with physical exertion and are a very formidable complication, because This can lead to compression of the spinal cord. The patient feels an acute pain in the back, then the paralysis of the legs and the violation of urination rapidly develop. If the hemangioma of the vertebra is complicated by a fracture, then surgical treatment and long-term rehabilitation are necessary.

Another possible complication is the compression of the growing tumor by the spinal cord or its roots. At the same time, a number of neurological disorders will develop: paresis, paralysis, impaired sensation, pain along the nerves.

The main symptoms of growing hemangioma are pain and neurological disorders. The peculiarities of localization (the lower thoracic and the upper lumbar spine) suggest a low probability of osteochondrosis or radiculitis. Symptoms of compression of the spinal cord or its roots cause one to think about the tumor process. An experienced neurologist or neurosurgeon can easily suspect a hemangioma.

The most reliable diagnostic methods are computed tomography (CT) and magnetic resonance imaging (MRI). When using these methods, the diagnosis is unquestionable. However, even an ordinary X-ray image of the spine is a good and often sufficient method of diagnosis.

Treatment of cutaneous forms is well developed and does not present any difficulties. However, laser treatment with hemangiomas, which is used for superficial tumor localization, is absolutely not suitable for such diseases in the case of the spine.

Small capillary hemangiomas do not usually require treatment, most often an independent reverse development (involution) of this new formation occurs. Specialized treatment is indicated in the presence of pain syndrome or with a large tumor size.

Surgical removal of hemangioma through open access is currently rarely used, because This method does not exclude relapse, but it is dangerous for the development of bleeding. Open surgical treatment of a patient diagnosed with a vertebral hemangioma is used for fracture of the vertebra or for compression of the spinal cord, when decompression of the nervous structures is necessary.

Radiation therapy and sclerotherapy also do not meet the necessary safety / efficacy ratio.

The main method of treatment at the present time is through percutaneous puncture vertebroplasty. In this case, the cavity of the tumor is filled with a special cement, which prevents relapse and strengthens the body of the vertebra. The operation is minimally invasive and is performed under local anesthesia. There is no need for long-term rehabilitation.