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Spinal Hemangioma Causes, Diagnosis, and Treatment Options

Spinal hemangiomas are the most common primary tumor of the spine. These tumors occur most often in the mid back and lower back.

When people come to UPMC with a spinal hemangioma, our experts find a treatment path that will least disrupt their life and return them to normal functioning.

UPMC doctors have pioneered and refined minimally invasive treatments that offer new hope to people with complex neurosurgical disorders.

Contact the UPMC Department of Neurosurgery

To make an appointment or learn more:

What Is a Hemangioma?

Spinal hemangiomas are benign tumors most common in the mid back (thoracic) and lower back (lumbar).

Hemangiomas appear most in people between the ages of 30 and 50. They occur in about 10% of the world's population, and most people have no symptoms.

Symptomatic hemangiomas are less than 1% of all hemangiomas, and are more common in women. If not treated, symptomatic hemangiomas can cause serious neurological issues.

At UPMC, we treat hemangiomas with surgical removal (resection) of the tumor or the affected vertebra, and radiation therapy for pain. We may also do ethanol injections and a laminectomy.

Spinal Hemangioma Causes and Risk Factors

The cause of spinal hemangiomas is unknown.

Spinal hemangiomas are more common in women. Babies with a high amount of estrogen in their bodies after birth may be more likely to have these tumors.

Hemangioma Symptoms and Diagnosis

People can have symptoms from spinal hemangiomas — or none at all. Our doctors use imaging tests, such as X-rays, CT scans, and MRIs, to diagnose hemangiomas.

Hemangioma symptoms

Most hemangiomas don't cause symptoms,

People who do have symptoms report:

  • Back pain.
  • Pain that radiates along a nerve due to an inflamed or irritated nerve root.
  • Spinal cord compression.

When to see a doctor

You should see your doctor if the pain starts to cause a lot of discomfort and limits your activities of daily living.

Hemangioma diagnosis

If your doctor thinks you may have a hemangioma, they'll run imaging tests:

  • X-ray — to check for a trabecular pattern on the bone. (Trabecular, or cancellous, bone is a lattice-shaped structure within the bone.)
  • CT scan — to check for a polka dot appearance in the bone.

If this appears, your doctor will order an MRI to see if the tumor has:

  • Expanded into the spinal column or spinal canal.
  • Encroached on the spinal cord.

An MRI can also show the extent of nerve damage in the spine and help plan surgical treatment.

Hemangioma Treatment

Treatment for hemangiomas depends on the size of the tumor and where it is.

At UPMC, we may use a combination of:

  • Embolization — to stop the blood flow to the tumor.
  • Surgery — to remove the tumor.
  • Radiation therapy — to treat the pain.

Ethanol injections with fluoroscopic guidance may also help ease pain.

After embolization, we may also remove the small bones that make up a vertebra (laminectomy) or remove the vertebra (vertebrectomy).

Long-term outlook

It's rare for spinal hemangiomas to come back after treatment. But you should still see your doctor on a regular basis to check the status of the hemangioma.