Spinal hemangiomas are the most common primary tumors of the spine. These benign (noncancerous) growths typically develop in the thoracic (mid-back) and lumbar (lower-back) regions. In most cases, spinal hemangiomas do not cause symptoms and are discovered incidentally during imaging for unrelated conditions.
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What Is a Spinal Hemangioma?
A spinal hemangioma is a benign (noncancerous) tumor that develops in the vertebrae — the bones that make up the spine. These tumors are composed of an overgrowth of blood vessels and bone tissue and are typically slow-growing.
Some key facts about spinal hemangiomas:
- Most are found in the thoracic and lumbar spine.
- Most people do not experience symptoms.
- Most frequently detected in individuals ages 30 to 50.
- Occur in approximately 10% of the population.
Types of spinal hemangiomas
Spinal hemangiomas are classified into two types based on their structure:
- Cavernous hemangiomas – Clusters of enlarged blood vessels and bone tissue, considered vascular malformations rather than tumors.
- Capillary hemangiomas – Form from small, thin-walled blood vessels interspersed with normal bone tissue. These can range in size from small lesions to those that replace entire vertebrae.
Stages of spinal hemangiomas
Spinal hemangiomas are also categorized by their size and potential for complications:
- Stage I (latent) – Slow-growing, well-defined tumors that may regress on their own.
- Stage II (active) – Have well-defined borders but may cause bone thinning or mild symptoms.
- Stage III (aggressive) – Indistinct borders with potential spinal cord involvement, occurring in less than 1% of cases.
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What Are the Signs and Symptoms of Spinal Hemangioma?
Most spinal hemangiomas are asymptomatic, meaning they do not cause any noticeable issues.
However, in rare cases, they may grow large enough to compress nerves or the spinal cord, leading to symptoms such as:
- Chronic back pain.
- Radicular pain – Pain that radiates along a nerve pathway.
- Spinal cord compression – Can result in weakness, numbness, or difficulty walking.
When to see a doctor
If you experience persistent back pain or any neurological symptoms that interfere with daily activities, consult a specialist for evaluation.
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How Do You Diagnose Spinal Hemangioma?
A spinal hemangioma is typically diagnosed using imaging techniques.
If a doctor suspects a hemangioma, they may recommend:
- Angiography – May be used in complex cases to visualize blood flow in the tumor.
- CT Scan – Detects a polka-dot appearance in the bone.
- MRI – Provides detailed images to assess spinal cord involvement and nerve compression.
- X-ray – Identifies a characteristic trabecular or lattice-like pattern within the vertebrae.
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How Do You Treat Spinal Hemangioma?
Most spinal hemangiomas do not require treatment unless they cause symptoms.
If intervention is needed, treatment options include:
Surgical resection (tumor removal)
- Recommended for large tumors causing spinal cord compression or severe pain.
- Aims to completely remove the tumor and restore spinal stability.
Embolization
- A minimally invasive procedure that blocks blood flow to the tumor, shrinking it over time.
- Often performed before surgery to reduce bleeding risk.
Radiation therapy
- Used for pain relief and tumor control.
- Ideal for patients who are not candidates for surgery.
Vertebroplasty or kyphoplasty
- Involves injecting bone cement into the affected vertebra to stabilize it and reduce pain.
Ethanol Injections
- Performed under fluoroscopic guidance to help shrink the tumor and relieve symptoms.
Monitoring
- If asymptomatic, many spinal hemangiomas are simply observed over time with periodic imaging.
Treatment success rates
- Most patients experience significant symptom relief following treatment.
- Spinal hemangiomas rarely recur after complete removal.
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Why Choose UPMC for Spinal Hemangioma Care?
At UPMC, our expert neurosurgeons and spinal specialists develop personalized treatment plans prioritizing patient comfort and optimal outcomes. We use cutting-edge, minimally invasive techniques to reduce recovery time and improve quality of life.
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By UPMC Editorial Staff. Last reviewed on 2025-05-16.
