Spinal hemangiomas are benign tumors that are most commonly seen in the mid-back (thoracic) and lower back (lumbar). Hemangiomas most often appear in adults between the ages of 30 and 50. They are very common and occur in approximately 10 percent of the world’s population. Most cases show no symptoms. Symptomatic hemangiomas represent less than one percent of all hemangiomas, and are more common in women than in men. If left untreated, symptomatic hemangiomas can cause serious neurological effects.
If a hemangioma is suspected, the doctor will order an x-ray to check for a specific pattern on the bone, called a trabecular pattern. Trabecular, or cancellous, bone is a lattice-shaped structure within the bone.
A CT scan may also show a polka dot appearance in the bone. If this appears, an MRI will be ordered to show whether the tumor has expanded into the spinal column or spinal canal, or encroached on the spinal cord. MRI can also show the extent of nerve damage in the spine and can assist in planning surgical treatment.
Most hemangiomas are symptom-free, but symptoms may include:
Treatment for hemangiomas depends on the size and location of the tumor. At UPMC, we use a combination of stopping blood flow to the tumor (embolization), surgical removal of the tumor, and radiation therapy.
Radiation therapy is effective in the treatment of pain caused by hemangiomas. Ethanol injections with fluoroscopic guidance have also proven effective in treating pain. Another treatment option is embolization followed by removal of the small bones that make up a vertebra (laminectomy) or removal of the vertebra (vertebrectomy).