spinal hemangioma - Causes, Symptoms, Diagnosis and Treatment
Hemangioma spine. - A benign tumor that affects one, sometimes several vertebrae. It is one of the most common neoplasms of the spine. Not prone to malignant transformation. In most cases, spinal hemangioma are asymptomatic. Less common causes pain. Can a cause of pathological fractures of the spine, accompanied by compression of the spinal cord or nerve roots. Diagnosis is exposed on the basis of the clinical picture and the results of additional studies. Treatment operative.
Hemangioma
spine.tumors of vascular origin. According to various reports occurs in 15-11% of the population, women are affected more often than men. spinal hemangioma is 1-1.5% of the total number of benign tumors of the skeleton. It ranked first among the bones of hemangiomas. Not prone to malignancy, malignant transformation occurs in less than 1% of patients.
More than 80% of hemangiomas localized spine in the thoracic region, often suffers VI thoracic vertebra. The second place is occupied by the prevalence of hemangioma of the lumbar. The defeat of the sacral and cervical spine is detected in 1% of patients. Usually, a hemangioma is detected in one vertebra, more rarely diagnosed multiple tumors, affecting 2-5 vertebrae. hemangioma of the spine Treatment carried out by experts in the field of Spine, neurology and oncology.
traumatic spinal injury.
According to researchers, spinal hemangioma develops in the following way: the innate inferiority of the vascular wall, arranged in a particular vertebra, in conjunction with the increased load, injuries and other factors causes recurrent hemorrhage. The thrombi formed hemorrhage region, and then activate osteoclasts (the cells that break down bone). On the site of the destroyed bone tissue grow new blood vessels to the inferior wall. spinal hemangioma increases in volume. Subsequently wall rupture of these vessels also new hemorrhage occurs, the process repeats. With the destruction of a large part of the supporting bone broken damaged vertebra, it becomes more vulnerable to mechanical stress. It increases the likelihood of developing a pathological fracture.
neurologist and vertebrologist on the basis of clinical symptoms and radiological findings. During the spine X-rays revealed the restructuring of the vertebra in vakuleobraznom, columnar or mesh form. When vakuleobraznom version spinal hemangioma can be seen in the form of oval vacuum zones, limited rims sealed sclerotic bone. When columnar form in a picture show up "bars" - the bony septum, easily visible against the background of the vacuum area.
When the mesh option X-ray picture of spinal hemangioma resembles fine mesh sponge. To clarify the nature and extent of destruction of bone structures and soft tissue after the patient X-rays sent to CT or MRI of the spine. On MRI determined hyper- or izointensivny freaked signal on T1 and T2-weighted images. The CT scan of the spine revealed the formation of a cellular structure that looks reminiscent of a honeycomb.
Percutaneous vertebroplasty needle. Classical technique used in the treatment of hemangioma of the spine with the 30-ies of the last century - the surgical removal of the modified soft tissue and bone resection of the affected areas. Today is a very narrow range of applications due to lack of efficacy and the high risk of profuse bleeding from vascular tumors or cavities. Shown at the spinal cord and nerve root compression.
Another classical method of treatment of spinal hemangioma is radiation therapy. As a result of irradiation of the tumor vessels are fallen down, soft-tissue component is exposed to fibrous degeneration and the affected bone, filled with capillaries or large vessels, it remains unchanged. The technique is more efficient and less dangerous as compared with surgery. Currently rarely used due to the large radial load and a high likelihood of developing neurological disorders.
Alcoholism hemangioma of the spine - a relatively new technique developed at the end of the XX century. The alcohol is introduced into the cavity of neoplasms, vascular thrombosis and causes destruction of the endothelium, resulting in decreased tumor size. Despite the good short-term results, this method of treatment of spinal hemangioma is not widely used because of the large number of complications in the long term. According to experts, have developed a technique, there is a fairly high probability of occurrence of pathological fractures. Other researchers suggest that alcohol abuse after spinal hemangiomas can develop paravertebral abscesses and myelopathy syndrome Brown-Sequard (spastic paralysis and disturbance of deep sensitivity in one half of the body, combined with a decrease in temperature and pain sensitivity in the other half of the body).
emoblizatsii method in the treatment of hemangioma of the spine applied to the end of the 60-ies of the last century. Currently, two methods of embolization - transvazalnuyu and selective. In the first case, emboli are introduced into the nearby blood vessels, in the second - directly to the neoplasm. Transvazalnaya embolization of spinal hemangioma is less effective, because after the procedure remain small feeder vessels, which subsequently can grow and nourish the tumor, causing its recurrence.
The most effective and safe treatment for spinal hemangioma in our days is considered a percutaneous puncture vertebroplasty, during which the bone cement is injected into the tumor. To fill the spinal hemangioma located in the thoracic vertebra, it takes about 4 ml of cement, in the lumbar vertebra - 6-7 ml of cement. The vessels are damaged or tumor cavity, are compressed and collapse. The cavity is filled with spinal hemangioma material providing high strength and integrity of the vertebra. Thus, at the same time it manages to eliminate the tumor and prevent the development of pathological fractures. Percutaneous vertebroplasty needle falls into the category of minimally invasive surgical procedures. Patients are stepping in just a few hours after the operation. Reducing the pain it has been celebrated on the first day.
Weather favorable. Usually spinal hemangioma are asymptomatic. Exodus during percutaneous vertebroplasty needle in most cases satisfactory, the possibility of complications ranges from 1-10%, most of the complications arise during the operation (total hyperthermia and pain during injection of cement) and does not involve the long-term effects. Malignant degeneration of spinal hemangioma is extremely rare.