What are haemangiomas of the spine?
Haemangiomas of the spine are benign vascular changes that form inside a vertebral body. They are a kind of "blood sponge" – a collection of widened, fine blood vessels within the bone tissue of a vertebra.
How do these vascular changes develop?
Haemangiomas of the spine usually develop through a local abnormality in the blood vessels, which often begins in childhood. The exact causes are not fully understood. They are frequently discovered by chance, for example when an X-ray or magnetic resonance imaging (MRI) scan of the spine is carried out for another reason. In many cases, they cause no symptoms at all and go completely unnoticed.
Should you be worried?
A diagnosis of a spinal haemangioma can sound unfamiliar and unsettling at first. In reality, however, these changes are almost always harmless. Haemangiomas usually grow very slowly or not at all, and they rarely develop into malignant tumours. Most people never notice them throughout their entire lives. Only in very rare cases can a haemangioma grow large enough to weaken the vertebral body and cause problems.
When can a haemangioma cause symptoms?
In the vast majority of cases, haemangiomas of the spine cause no symptoms. Only if they become unusually large can they make the bone unstable or press on nerve structures. This can then show up as back pain, numbness, or in rare cases weakness or paralysis. Such complications are, however, extremely uncommon.
The question of whether a haemangioma can become dangerous often comes up. The answer is: in the great majority of cases, it remains a harmless finding that needs no treatment and does not affect daily life. The likelihood that a spinal haemangioma will cause symptoms is very low.
How is a spinal haemangioma detected?
Haemangiomas are most often discovered by chance, for example during an MRI or CT scan of the spine carried out for a different reason. The images show typical changes in the bone that experienced doctors can readily distinguish from other, more serious findings. A tissue sample is generally not needed, because the appearance of a haemangioma on imaging is very characteristic.
What happens after the diagnosis?
When a spinal haemangioma is found, no further treatment is usually needed. It is enough to document the finding. Only if symptoms do occur, or if the haemangioma is particularly large, will a specialist discuss whether further investigations or check-ups are necessary. In rare exceptional cases, treatment may be considered, for example if the vertebral body becomes unstable or nerves become compressed. There are various options available, from targeted sclerotherapy and cement filling to surgery. Such procedures are, however, very much the exception.
What does the finding mean for everyday life?
A spinal haemangioma is in almost all cases an incidental finding with no clinical significance. It does not limit you, cause symptoms, or affect your life. Sport, exercise, and everyday activities remain perfectly possible. No special rest or precautions are necessary. Most people live for many years with such a finding without ever noticing anything.
When should you seek medical advice?
If sudden severe back pain, numbness, weakness in the arms or legs, or other unusual symptoms occur, it is always a good idea to see a doctor. In most cases, however, something other than the haemangioma is the cause. The discovery of a haemangioma is usually a coincidence and no cause for concern.
Haemangiomas of the spine are therefore, in the vast majority of cases, a harmless finding that plays no role in everyday life. If you have any uncertainties or questions, a reassuring conversation with your treating specialist can help put your mind at ease and place the finding in the right context.
