Symptoms of spinal hemangioma

Vertebral hemangioma is a relatively common benign tumor that can occur at any age, especially in women after middle age. As a type of benign tumor, the symptoms of most hemangiomas are not obvious, and they are mainly found in the lower thoracic spine and upper lumbar spine. The pathological manifestations are many proliferating capillaries and dilated sinuses. Studies have shown that 10% of people have this type of spinal hemangioma on their spine.

1. What is vertebral hemangioma?

Vertebral hemangioma is a relatively common benign vertebral tumor, which is more common in the lower thoracic spine and upper lumbar spine. 60% of vertebral hemangiomas grow in the thoracic spine, 30% in the lumbar spine, and about 10% in the cervical spine and sacrum. The vast majority of hemangiomas are asymptomatic and are discovered accidentally during examinations. Vertebral hemangiomas can be pathologically divided into cavernous hemangiomas and capillary hemangiomas. Small hemangiomas are mostly asymptomatic, and a few only cause localized dull pain. When the lesions are large, they can compress the spinal cord and nerve roots and cause corresponding symptoms. Typical vertebral hemangiomas often involve the vertebral body. A few lesions can spread to the pedicles, lamina, and spinous processes. However, most vertebral hemangiomas are asymptomatic and are often discovered accidentally. This type of lesion is most commonly associated with lesions in the mid-thoracic spine. Spinal cord compression is less common and occurs as a result of fracture of the affected vertebra with associated soft-tissue mass or hematoma formation. Vertebral hemangioma will not worsen and is a benign lesion, so please do not worry.

2. Clinical manifestations of vertebral hemangioma

The disease can occur at any age, and the clinical symptoms are related to the location and growth rate of the tumor. It is usually asymptomatic and is discovered incidentally. In cases where the disease is located in the spine, a few cases may develop symptoms of spinal cord or nerve root compression, and pathological fractures and paraplegia are common complications.

However, a small number of hemangiomas will cause local pain due to their expansion and growth, and an even smaller number of hemangiomas will grow outside the vertebral body. If the nerve roots are compressed, it will cause radiating pain in the trunk or limbs; if the spinal cord is compressed, it will cause limb weakness or even paralysis.

3. Imaging examination of vertebral hemangioma

On X-rays and CT films, hemangiomas often show characteristic "fence sign", "honeycomb sign" or "dot sign". On MRI, it appears as a T2 high signal area with regular borders. The above examinations can often establish the diagnosis of hemangioma. Sometimes hemangiomas also need to be differentiated from other tumors, which requires puncture biopsy. A needle biopsy carries the risk of bleeding or epidural hematoma.

4. Treatment options for vertebral hemangioma

Hemangiomas that don't cause symptoms don't require treatment. If local pain is obvious, radiotherapy and vertebroplasty can be used. Surgical treatment is only considered when the tumor invades the spinal canal and causes spinal cord compression, leading to neurological dysfunction. The purpose of the surgery is to relieve nerve compression. Depending on the patient's specific condition, vertebroplasty and other procedures can be selected.