Hemangioma of the spine - what is it? How to treat a hemangioma of the spine

According to statistics, among the main causes of death in our country, in addition to accidents and cardiovascular disease, belong to oncological diseases. And in the majority, especially if the tumor is malignant, a similar diagnosis sounds like a sentence. Somewhat different is the situation with the detection of benign education. In such cases, the prognosis is considered more favorable when treatment of pathology is possible, and its result leads to complete healing of the patient. It is to such cases that the hemangioma of the spine is involved.

What it is?

In the general view, such a disease can appear on the skin as well as affect various internal organs and systems, often remaining hidden from the eyes of their carrier all their life or finding themselves accidentally when examining a disorder, including pathological changes on the part of the bone System. If we talk specifically about the diagnosis of "spinal hemangioma" - what is it, then modern medicine defines it as a benign neoplasm, which is a conglomerate of vascular bundles, sometimes displacing bone tissue. In connection with this, this pathology is also called "vertebral angioma" or "arteriovenous malformation".

Let's find out, the very name of "hemangioma" (spine) - what is it? The term comes from the Greek words haima - blood, angeon - vessel, "oma" - ending, characteristic of all pathological tissue growths.

The tumor itself grows slowly and does not form a metastasis. The primary characteristic localization is the body cavity of the vertebrae, as well as the cartilage substance between them. However, there are other, more rare and unusual locations in the bones. In the substance itself, the spinal cord also often reveals dividing cells of these pathological vessels, confirming the local origin of the growing formation.

Among all tumors of the osseous system, the hemangioma of the body of the spine occupies a tenth of the pathological formations presented here, flowing with violent clinical symptoms, and being a casual finding in pathomorphological examination.

Etiology of the disease

About such a disease, as the hemangioma of the spine - what it is, where it is located and how it manifests itself - the reader already had primary surface ideas. Now is the time to begin to study the causes and mechanisms of the development of such a benign vascular tumor.

Unfortunately, even at the beginning of the 21st century, medical science does not give exact definitions of the etiology of this neoplasm. It is customary to identify predisposing factors of the disease. The main one is a family predisposition, which determines the presence of a defect in genes and mutations in the appearance of congenital disorders of the structure of the vessel wall at the level of the vertebra.

In addition, a certain contribution is made by such factors as local tissue hypoxia and an elevated level of the female hormone estrogen, which is confirmed by statistical data. This pathology is found in the female population of older age almost 5 times more often than in men.

Pathogenetic features

On the already changed vertebra after birth throughout life will be given various mechanical and physical effects that can contribute to the emergence of permanent microtraumas and hemorrhages from pathologically thin and fragile vessels. To stop hemorrhages, the body activates clotting reactions, including the formation of a massive number of thrombi at the local level. At the same time, osteoclast cells are activated, which destroy the bony beams of the vertebral bodies and promote the growth of newly formed vessels in the released place after the process of recanalization of blood fibrin clots. So, slowly, but surely, there is an increase in the pathological vascular conglomerate.

Characteristic localizations of lesions of the vertebrae

Hemangioma of the thoracic spine is the most common level of lesion, especially within its sixth vertebra. This localization occurs in 85 percent of observations.

In 2% of cases, lesions of the cervical or sacral vertebrae are possible . There are also clinical observations of the development of multiple hemangiomatosis, affecting from 2 to 5 vertebral bodies.

Hemangioma of the lumbar spine, especially its upper levels, the second most frequent occurrence of tumor localization.

Given the characteristic sites of tumors, it is not difficult to guess what causes the main symptomatology of the disease. It manifests itself against the background of local negative dynamics in the form of changes in the parameters of the body of the pathologically formed vertebra, its height with the development of collapse, and possible compression of nearby neural trunks by an education such as a spinal hemangioma. The size of the tumor, especially if it occupies the entire vertebral cavity, directly affects the clinic and the degree of manifestation of the pain syndrome.

Clinic with hemangiomas of the spinal column

As mentioned above, the symptomatology of the disease is most often erased. And the patient seeks medical help for back pain, caused by a completely different pathology. However, hemangioma can give the clinic pain in those cases when its size exceeds 1 cm, which is an alarming symptom - a kind of forerunner of the future compression fracture of the affected vertebral body. A persistent pain syndrome characterizes the growth of a specific localization of the hemangioma as aggressive, especially in its severity and persistence. Such cases amount to 4%. The pain is caused by the compression of nerve endings and spinal matter due to blood filling of the tumor vessels with active movements, slopes, changes in the position of the trunk in space, and thrombosis with subsequent tension of the ligamentous apparatus of the spinal column.

For example, the hemangioma of the cervical spine may be manifested by local pain when turning in the neck or bending the body, unpleasant sensations at the site of the lesion, including when performing various physical exertion. Specific are night burning pain in the area of tumor localization.

The usual load becomes dangerous and can lead to a compression fracture when the pathological process affects more than half of the vertebral body. If a violation of the integrity of the vertebra is already observed, the compression of the spinal cord substance can manifest itself with serious changes, up to the disorder of urination, or motor paralysis.

Diagnostic measures to detect pathology

The detection of hemangioma is difficult due to the characteristics of its long and slow growth, as well as asymptomatic flow in most cases.

The main modern diagnostic methods are computer and magnetic resonance imaging, X-ray examination of the spine, as well as angiography of pathological education with the introduction of contrast and the production of a series of images. In addition to detecting and establishing a diagnosis of hemangioma, additional survey methods are performed to monitor and control the benign neoplasm. Tracking the rate of growth and taking into account the pathomorphology of the tumor structure itself, thanks to the dynamic observation, the question of how to treat the hemangioma of the spine is solved.

Patient management with hemangioma of the spine

With constant monitoring of the tumor, the waiting strategy for patient management is based on a stable and slowly progressing development. Only in the case of aggressive growth, medical manipulations are performed.

Depending on the location and size of the hemangioma selected method of therapy.

Sclerotherapy - the main and effective method of exposure

To stop growth, a new formation from the inside with a special needle through the skin is filled with a special substance that resembles bone cement properties. Such material is polymethylmethacrylate, after which the vessels of hemangioma are emptied, and the cavity of the vertebra is strengthened. Therefore, a similar method of treatment is called percutaneous puncture vertebroplasty. It is performed under general or local anesthesia.

As a form of sclerotherapy, the introduction of a foaming agent is used, which is delivered directly to the tumor with the help of a catheter. It acts as an embolus, clogging the feeding vessels and stopping the delivery of nutrients to the focus of pathological growth, gradually leading to its reverse development and sclerosis. This method is used in the absence of danger of compression fracture of the vertebral body, as well as the probability of hemorrhage from the hemangiomatous vessels.

The surgical method is resorted to when there is a need for decompression of the substance of the spinal cord and its roots with the already broken bone structures and the compression of nearby neural elements. Resection of the education itself is also carried out.

Dangers and cautions on the tactics of managing a patient with hemangioma

The previously known radiation method of influencing hemangioma is currently used quite rarely due to the availability of more effective and safe techniques.

It must be remembered that if a person has a similar pathological formation, such effects on the body as heating, massage, any manual and physiotherapy procedures, as well as folk medicine, should be avoided to minimize exacerbations and provocations of growth of the pathological focus.

Unfortunately, in modern conditions of life, including the environment, food, water and air, excellent health can boast a few. Hemangioma, although it refers to the tumor processes, but still has a benign course in most cases. And with its dynamic observation and the absence of aggressive growth, the quality of life does not suffer.