Spinal hemangiomas are common vascular formations found within the bones of the spine. This article explores what spinal hemangiomas are and the current understanding of factors contributing to their development.
Understanding Spinal Hemangiomas
A spinal hemangioma is a benign, non-cancerous growth composed of an abnormal collection of blood vessels within a vertebra, one of the bones that make up the spine. These vascular malformations are the most common primary tumor of the spine, affecting an estimated 10% of the global population. They form a mass that can appear like a honeycomb or lattice pattern within the bone on imaging. Most spinal hemangiomas do not cause symptoms and are often discovered incidentally during imaging for unrelated reasons.
Factors Contributing to Their Development
The precise reasons why spinal hemangiomas develop are not fully understood, but current research suggests several contributing factors. The primary theory points to a congenital origin, meaning these formations are present from birth due to developmental anomalies. They are considered hamartomatous lesions, arising from disorganized cell growth rather than being true neoplasms.
Genetic influences may also play a role, with some studies suggesting a familial link or an association with certain genetic variations that regulate vascular development. Hormonal factors are another potential influence, as these growths are observed more frequently in females and can sometimes enlarge during pregnancy. This suggests that fluctuating hormone levels might impact their growth.
Spinal hemangiomas are generally not caused by external factors such as injury, trauma, or lifestyle choices. Unlike infantile hemangiomas, which can spontaneously regress, spinal hemangiomas typically do not shrink or disappear on their own.
Detecting Spinal Hemangiomas
Spinal hemangiomas are frequently identified incidentally during medical imaging of the spine for other health concerns. If a spinal hemangioma does become symptomatic, common indicators include localized back pain, which may worsen with activity. Less frequently, if the growth expands significantly or puts pressure on the spinal cord or nerves, it can lead to neurological symptoms such as weakness, numbness, or a tingling sensation in the arms or legs. Diagnostic imaging, specifically Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans, are crucial for identifying and characterizing these formations. An MRI can help determine if the growth is impacting the spinal canal or nerves, while a CT scan might show a distinctive “polka dot” or “corduroy” pattern within the bone.
Management Approaches
Since most spinal hemangiomas are benign and do not cause symptoms, the typical approach after detection is observation and periodic monitoring. Intervention may be considered if the hemangioma leads to persistent pain or neurological symptoms. Treatment options for symptomatic hemangiomas include non-surgical methods such as embolization, which blocks the blood supply to the growth, or radiation therapy to reduce its size. In some cases, particularly if there is significant spinal cord compression or instability, surgical options may be necessary to remove the growth or stabilize the affected vertebra.