Vertebral hemangioma (spinal angioma) is the most common benign neoplasms of the spine. This pathology is usually asymptomatic and detected randomly (due to the specific external characteristics) during diagnostic studies (MRI, CT, x-ray examination) on the question of various diseases and pathological processes (pain in the back, communicable diseases or injury of the spine, etc.).
They belong to benign tumor tumors, mainly localized in the middle (thoracic) and lower (lumbar) spine area.
The pathological process is quite common and occurs in 10% of the population (in accordance with the results of the autopsies). A large part is detected as a result of standard radiographic examinations of the spine.
Often small tumors are not detected on radiographs, and visualized with the help of modern methods of radiation diagnostics – CT, MRI or at autopsy. Cancer mainly develops in the adult population in the period from 35 to 55 years. The frequency of the susceptibility in the power of unexplained reasons above in females and is most manifest in the fourth decade of life.
The symptomatic manifestation
A large part of vertebral tumors during life has asymptomatic. Destruction of vertebral body, or the impact on the adjacent intervertebral foramen (the exit point of nanocores from the channel of the spine) often becomes a causal factor in the development of pain symptom in patients. Increasing physical activity (figurante, household activity, etc.) can provoke pain. This is mainly due to increased axial load on the body damaged by the tumor of a vertebra. Primarily vertebral tumors occur without any symptoms.
Symptomatic manifestations are less than 1% of all hemangiomas, and often occur in women, unlike men. In the absence of appropriate treatment symptomatic form can subsequently cause serious neurological disorders in the patient.
Symptomatic picture is from:
- pain in dorsal region extending along a nerve bundle as a result of inflammatory process or irritation karakorecho;
- signs of compression (squeezing) of the spinal cord
Performed vascular cavity, causing displacement of nearby bone tissue. Favorite place localization acts of the thoracic part of the spine, however, can occur in another Department.
In case of suspicion, the doctor sends the patient for rentgenograficheskoe examination of the spine to assess the integrity of vertebral bone and the possible presence of characteristic changes in it. The typical vertebral body trabecular (spongy, lattice) structure.
The results of radiographic studies is determined by the characteristic of hemangioma symptoms in the form of “corduroy fabric”.
- Computed tomography in axial cut showing pinpoint inclusions, which resemble by their appearance “polka dot”, formed as a result of thickened trabeculae of the vertebral body. In the case of the above-described pattern is assigned the next test – MRI to ascertain the presence or absence of proliferation of neoplastic growths on the vertebral column, spinal canal, or pressure on the spinal cord.CT with aggressive form of the disease indicates the presence of point foci of sclerosis or inclusions in the form of “dots” on the transverse images of the vertebrae.
- MRI provides information about magadanlag components of the hemangioma ( fat or water inclusion) is much more effective than CT.
Differential diagnosis is with metastases of malignant tumors of other organs.
MRI of the spine allows us to estimate the degree of destruction of the spinal nerve and helps in planning the surgical treatment of the patient.
Aggressive vertebral hemangioma
Aggressive form can the inside of the expanded vertebral body, penetrate okolofutbolnye soft tissue to reach the spinal canal, squeezing the spinal cord or contributing to pathological vertebral fractures.
MRI-gram tumor sometimes like metastases, however, the presence of thickened trabeculae allows to differentiate it from other malignant tumors.
Acts CT is more sensitive than MRI.
In these tumors therapy is mostly not required. Therapy is indicated if there are violations of neurological status or a pain syndrome.
In the presence of such symptoms is possible following treatment, individual way:
- radiation therapy;
- intravascular balloon kyphoplasty or transarterial embolization of the tumor with further laminectomy and so forth.
Open surgical procedures can be complicated by bleeding.
Symptomatic form is primary resection of the damaged vertebra in combination with radiation therapy.
The thickness of the tumors can be injected ethanol (it helps to nekrotizirovannye of tumor tissue with subsequent scarring) or held laminectomy (to relieve compression of the spinal canal).
The amount of treatment depends on the size and localization of tumors.