From the Guidelines
Hemangiomatous involvement in the lumbar spine refers to the presence of benign blood vessel tumors, such as vertebral hemangiomas, which can be associated with underlying spinal dysraphic malformations, particularly in cases with high-risk cutaneous markers like infantile hemangiomas or atretic meningocele, as noted in 1.
Key Points
- Hemangiomatous involvement in the lumbar spine can be associated with spinal dysraphism, a condition where there is an abnormal formation of the spinal cord or vertebrae, as discussed in 1.
- High-risk cutaneous markers, such as infantile hemangiomas or atretic meningocele, can indicate an increased risk of underlying spinal dysraphic malformations, as seen in 1.
- The presence of segmental hemangiomas in association with LUMBAR syndrome can be associated with spinal and genital urinary malformations in up to 55% of cases, highlighting the importance of evaluation and management, as mentioned in 1.
- The management of infantile hemangiomas, including those associated with spinal dysraphism, typically involves evaluation by a hemangioma specialist and may require timely referral for treatment, as recommended in 1.
Clinical Considerations
- When evaluating patients with hemangiomatous involvement in the lumbar spine, it is essential to consider the possibility of underlying spinal dysraphic malformations and to perform a thorough diagnostic workup, including imaging studies and physical examination, as implied by 1.
- The characteristic appearance of vertebral hemangiomas on imaging, including a "polka-dot" pattern on CT scans and hyperintensity on T1 and T2-weighted MRI sequences, can aid in diagnosis, although this specific information is not directly provided in the given references 1.
- Treatment options for symptomatic vertebral hemangiomas may include observation, radiation therapy, embolization, vertebroplasty, or surgery, depending on the severity of symptoms and the presence of spinal cord compression, as generally recommended in clinical practice for such conditions.
From the Research
Definition and Overview
- Hemangiomatous involvement in the lumbar spine refers to the presence of a benign blood vessel tumor, also known as a vertebral hemangioma, in the lumbar region of the spine 2, 3, 4, 5, 6.
- Vertebral hemangiomas are common benign lesions that can occur in any part of the spine, but are most often found in the thoracolumbar region 2.
Symptoms and Presentation
- Most vertebral hemangiomas are asymptomatic and are discovered incidentally during evaluation of spinal pain 2, 4.
- However, in some cases, hemangiomas can cause symptoms such as back pain, neurological deficit, and spinal canal stenosis 2, 3, 5, 6.
- Rarely, hemangiomas can cause devastating complications such as pathological fractures of the spine and neurological disability 3.
Diagnosis and Treatment
- Diagnosis of vertebral hemangiomas is typically made using radiographic and MRI studies 2, 5.
- Treatment options for symptomatic vertebral hemangiomas include surgical intervention, percutaneous ethanol injection, radiofrequency ablation, and radiation therapy 4, 6.
- Surgery can be effective and safe, and can significantly improve patient outcomes, especially in cases where there is compression of the spinal cord and/or nerve roots 3, 5, 6.
- Radiation therapy can also be used to treat aggressive vertebral hemangiomas, and can help to prevent recurrence 4.