Rheumatology
Rheumatology

Hemangioma of the vertebrae( spine) - symptoms and treatment, danger

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There are many medical terms that are often distorted - it's unknown why, but this sad fate befell the spine. It is known that this design represents a single functional structure - a vertebral column, with physiological curves.

However, the bone base of the spine is the individual vertebrae. The most often pronounced erroneous term is the expression "intervertebral hernia".The correct name is "intervertebral".

The second common distorted term is "spinal hemangioma".In fact, no one has ever seen a hemangioma in the eye that has spread throughout the entire spine.

It's right to say - "vertebral hemangioma", as this formation occurs in one, single vertebra.

However, since we are used to saying wrong, we will not deprive us of the opportunity to hear the usual terms. We'll tell you what "spinal hemangioma" is about treatment, signs of hemangioma and the reasons for its occurrence.

Contents

  • 1 Hemangioma of the spine - what is it?
  • 2 What is dangerous for the hemangioma of the spine?
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  • 3 Symptoms of a hemangioma in the vertebral body
    • 3.1 About radicular symptoms
    • 3.2 About spinal cord lesions
    • 3.3 Dangerous sizes of spinal hemangioma
  • 4 Treatment of spinal hemangioma -
  • 5 methods Contraindications for spinal hemangioma
  • 6 Forecast

Hemangioma of the spine - what is it?

Hemangioma of the vertebra

Hemangioma of the spine is, above all, a tumor. The tumor is vascular and the hemangiomas can meet anywhere in the human body, wherever there are blood vessels. So, there are hemangiomas of the liver and brain.

There is no hemangioma only where there are no blood vessels, that is, in the vitreous humor inside the eyeball, and in the joint cavities, since the cartilaginous tissue is fed by synovial fluid, and not at all with the help of blood vessels.

In the case of the spine, the hemangioma "hides" in the spongy bone substance, in the body of the vertebra. It is important to know that hemangioma is a benign tumor, and never degenerates into a malignant tumor. That is, the end of "-oma", characteristic of all tumors, does not tell its owner that they "have found cancer."

Hemangioma of the vertebral body is most often a completely random finding during the examination, for example, when performing a computer( CT) or magnetic resonance( MRI) tomography.

About the causes of

Hemangioma of the spine in adults, which was found, for example, a week ago, could have formed at any time, for example, for a month, a year or ten years before the examination. There is no difference between men and women in the relative frequency of occurrence of haemaginomas: the chances are absolutely equal.

According to statistics, these tumorous formations in the spine are found in every tenth person. Considering that in the cervical, thoracic and lumbar spine there will be( 7 + 12 + 5 = 24) vertebrae( sacrum and rudimentary vertebrae of the coccyx not taken into account), then the chance that in any vertebra during the life will appear hemangioma, on average, is regarded as 1: 240.

The reasons for the appearance of the vertebral hemangiomas are probably so many that medicine can not name any. Most often referred to as the propensity to congenital emergence( genetic predisposition).Sometimes you can hear a version that a prolonged exposure to direct sunlight stimulates the appearance of these vascular tumors, but so far there has been no convincing data for this data.

Therefore, it is impossible to say at the present stage of the development of medicine what to do( or not do) to avoid the development of hematomas. Their causes are hidden, as well as the factors of increased risk of development.

What is dangerous for the hemangioma of the spine?

dangerous hemangioma of the spine

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The most important thing is the fact that hemangioma never metastasizes, because it is a truly benign tumor. Nevertheless, it is capable of slow growth.

In the event that the hemangioma is located inside the spongy substance of bone tissue, it can threaten her( bones) with destruction.

Let us remember that a malignant tumor grows through and through, and destroys any organs and tissues that it meets on its way. This character of growth is called infiltrative, or invasive.

The vertebral hemangioma is a slowly growing, benign tumor, so it does not germinate, it simply "gently" pushes away the bone tissue to the sides. Since the spongy bone already has much less mechanical strength to angular loads, as a result, the cells-osteoclasts produce resorption, or bone resorption along the sides of the focus of the hemangioma growth.

This leads to the fact that the support area for the overlying intervertebral disc, which is the body of the vertebra, becomes brittle, hollow and loses strength, as well as resistance to stress.

This can lead to vertebral body fractures, which can cause compression and even penetrating injury of the spinal cord with the resulting fragments when they are displaced.

A compression or compression of the spinal cord can occur without any fracture, for example, when the hemangioma directly penetrated the central canal and began to squeeze the dura mater, causing tension of the nerve roots.

Symptoms of hemangioma in the body of the vertebra

It is appropriate to make some comparison between the hemangioma of the vertebra and the hernia of Schmorl. Indeed, there are common symptoms between these formations:

  1. Both hemangioma and Schmorl's hernia destroy the bone tissue of the vertebra;
  2. Both formations are prone to enlargement, only with a hernia the defect of the bone is limited by the thickness of the disc, and with hemangioma, it is, in principle, limited only by the growth rate of the tumor;
  3. Both processes are asymptomatic.

Symptoms of hemangioma in the body of the vertebra Even hemangioma of the cervical spine, which is the most "delicate" due to the large number of vascular-neural bundles, the presence of vegetative centers and ganglia, is asymptomatic. Although, according to surveys, most often still affects the thoracic and lumbar.

Perhaps this is because just the cervical section is examined somewhat less with the use of magnetic resonance and computer tomographs than the lumbar and thoracic department.

It is known that the greatest number of studies of the spine is in the lumbar region, since the "most vulnerable" is the zone of transition of the last, fifth lumbar vertebra into the sacrum and surrounding tissues.

In rare cases, with a large vascular tumor size, pain syndrome may occur. In addition to local pain in the back, the vertebra may break down, which is manifested by a decrease in its height. This phenomenon is called vertebral collapse.

Most often, the collapse of the vertebra is manifested by neurologic symptoms - the appearance of radicular syndrome, or signs of a lesion of the spinal cord.

About radicular symptoms

Symptoms of radicular symptoms include the appearance of sharp, shooting pains during coughing, sneezing, straining, laughing, and abrupt movement.

Pains can occur suddenly, like electric shock. Everyone knows "lumbar lumbago" or lumbago. This is a sharp pain, giving in the leg, which causes the patient to "stand still and gasp."

Secondary signs of radicular symptoms include spasm of the striated, skeletal musculature of the back. The fact is that the root, which was subjected to pressure collapsed, lost the shape of the vertebra, swells.

But the root does not "hang" in an empty space. Edema spreads to neighboring muscles. As a result, there is an episode of acute pain in the back.

For the sake of justice, it should be said that such pain is most often caused by discogenic radiculopathy, and the intervertebral disc, its protrusions and hernias, and also osteochondrosis are to blame for it.

  • The probability of such a primary detection of fracture of the vertebral body by hemangioma is very small, and is on average 0.1%, that is, one percent of all detected patients with vertebral hemangioma.

About spinal cord lesions

When the vertebral body is fractured, there may be a compression of the spinal cord with a bone fragment that penetrated the central canal, and in severe cases even a penetrating spinal cord injury.

Since the spinal cord is behind the vertebral bodies, the front sections of the spinal cord, as well as its lateral cords and posts, are most often squeezed. In these cases, there will be a characteristic clinical picture corresponding to the defeat of the anterior horns of the spinal cord and the anterior( ventral) roots. The patient will have:

  • Peripheral paralysis of muscles located below the level of lesion, without loss of sensitivity and without pain;
  • In the defeat of the lateral cord, central paralysis occurs on the side of compression, with increased muscle tone, increased tendon reflexes;
  • In the case of compression in the thoracic region, there is paralysis in the leg on the side of the lesion, in case of collapse of the cervical vertebra in the zone above the cervical thickening, paralysis and arms and legs occur on one side;
  • Loss of both pain and temperature sensitivity( while retaining tactile) on the opposite side of the body is also possible.

Of course, the symptoms of such severe spinal cord lesions are rare, but if weakness occurs in the arm or leg, and sensitivity disorders, one should think not only of cerebral stroke, but of spinal processes that can lead to similar symptoms.

Hazardous dimensions of the spinal hemangioma

Often, patients are asked whether there is any stage of hemangioma growth that increases the risk of complications. In other words, they are interested in the dangerous dimensions of the vascular coil with the diagnosis "spinal hemangioma".

These dimensions are individual. If to argue approximately, at a tumor size up to 1 cm in diameter, the danger is small, and if this size is exceeded, the risk of complications increases accordingly. But it depends on many reasons, for example:

  • On what department the hemangioma is located in. In a massive fourth lumbar vertebra, the size of 1 cm in a large man may be "tolerable", and the same size in a fourth cervical, smaller vertebra in a girl may already be critical;
  • On the rate of its growth;
  • From localization in the vertebral body;
  • From the state of bone tissue. For example, in osteoporosis in postmenopausal women, the risk of vertebral fracture is higher than in young men, even if they have a smaller hemangioma.

Thus, it is not very reliable to be guided by the size of the tumor for the prognosis: many factors need to be taken into account, and this should be done by the doctor.

By simple - if the tumor grows and occupies a volume equal to 50% of the vertebral body - you need to think about the operation. First of all, you need to state that all conservative methods such as acupuncture and massage, visits to osteopaths and manual therapists are completely ineffective, and serve as an excellent way of taking money away from a frightened patient.

Treatment of a spinal hemangioma -

Treatment of a hemangioma of a backbone

methodsAgain there is a complete analogy with the treatment of hernia Schmorl: what is hidden by nature inside the vertebra, can not be eliminated without getting inside.

Therefore, for the treatment of hemangioma, there is such a method of simple surgical intervention as percutaneous puncture vertebroplasty.

For this, under the X-ray control, a special "bone glue" is introduced into the necessary place of the vertebra, which solidifies, destroys the vessels and connects the cavity in the vertebra. It consists of cement, antibacterial substance and radiopaque material, for control. This method is very similar to the filling of a sick tooth.

For the operation of the patient, you only need to "prick in the back."This method is loved in all countries, because it is cheap, minimally invasive, does without cuts and blood, and passes painlessly.

After the operation, the patients can move the next day, and perform it, most often, under local anesthesia: the anesthetic is sent forward, and the needle moves behind it.

Contraindications for hemangioma of the spine

  • If there is a stable or a small hemangioma of the spine, are there contraindications to vertebroplasty?- Yes. Do not need extra operations.

Since the method is very simple, cheap and effective, in medical institutions( especially paid ones), there was excessive advertising of this method: who from the management of a private clinic for one injection does not want to put 130,000 rubles in cash, and for every vertebra.

But the fact is that small hemangiomas, as well as stable ones, should not be touched at all. Contraindications are just the stability, lack of growth and small size of the tumor. Of course, we should not forget about such contraindications as inflammatory and tubercular lesions of the vertebrae, elderly and senile age with the phenomena of multi-organ failure and other general contraindications.

Forecast

In most cases, the vertebral hemangioma does not interfere with life at all. Hundreds and thousands of generations of people lived quite peacefully with these vascular tumors, and died in old age from other causes.

And only the progress of visualizing diagnostic methods has led people to become aware of these entities, to worry and to try to take any measures. In the event that the tumor is small, and does not cause any unpleasant sensations, then you should not worry.

The only thing that can be done is to exclude weight lifting and not gain excess weight.

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