Definition
Hemangiomas in the spine are common benign tumors that affect about one in ten people. They are rarely detected and cause symptoms in only a few cases. Hemangiomas are so-called “blood sponges”, which consist of blood vessels.
Hemangiomas can occur all over the body, but the most common locations are on the scalp, neck, liver and bones. Hemangiomas in the spinal column are usually no cause for concern. Only in rare cases can they cause symptoms and complications.
Causes
The exact cause and development of hemangiomas is not completely known. As a rule, they are congenital tumors that develop during the embryonic period. There are several subtypes of hemangiomas, which differentiate the exact cell composition of the small tumors.
All variants, however, are ultimately vascular malformations that can be very strongly supplied with blood and therefore receive their red-blue color. The vascular malformations possibly originate from placental cells. In most cases, the cause of the development of a hemangioma is not investigated in detail.
In medical terminology, these tumors are often called “idiopathic”, which means that there is no identifiable cause. Hormonal changes during pregnancy are also discussed. Hemangiomas usually grow within the first months of life until growth stops.
After about a year, in many cases the tumors recede until they are completely decomposed, which can take years. Large hemangiomas, on the other hand, often remain for life. The development of hemangiomas in adults is being discussed. In old age, new hemangiomas may occur, but these are probably due to a hereditary predisposition and pre-existing vascular dilatation. A complete new formation of a real hemangioma in adulthood is rather unlikely.
Associated symptoms
A hemangioma is a benign tumor that does not cause any symptoms on its own. For this reason, a hemangioma of the spinal column is not detected in most people or is diagnosed by chance in old age. Due to its location in the spine, however, it can impair surrounding anatomical structures, which can result in unpleasant and sometimes dangerous symptoms.
Due to its position in the vertebral body, pain can occur when under pressure or at rest. The hemangioma can also press on blood vessels, muscles or the spinal cord, which, in addition to pain in this area, can lead to functional limitations and other neurological symptoms. If the hemangioma grows inside the spinal canal, a so-called “spinal canal stenosis” can develop, which is associated with a narrowing of the spinal cord and neurological symptoms.
These can range from position-dependent movement and sensitivity disorders to complete paresis, severe pain and functional limitations of the rectum and bladder. Since the hemangioma is a dilatation of blood vessels, minor injuries and bleeding from the hemangioma can always occur. Depending on the size of the tumor, undetected larger bleedings can sometimes occur, which in turn cause neurological symptoms and pain in the back.
The majority of all hemangiomas are symptom-free and therefore pain-free. At the spinal column, hemangiomas may be located in the vertebral body or in the vertebral arch and cause pressure pain at the corresponding vertebral body due to displacement of the bone. However, the pain caused by the hemangioma is rarely severe. Worse pain and symptoms are only to be expected when a hemangioma grows into the spinal canal, where it leads to a constriction involving nerves. This can sometimes lead to a dragging pain in various parts of the body.
