(I received a question from someone who has a hemangioma on her 9th thoracic vertebrae with compression of her spinal cord. She asked anonymously for information, so I’ve written this overview.)
A hemangioma is a vascular mass that is most commonly found in the thoracic spine. It can be progressive, weaken the vertebrae and even cause it to collapse as it infiltrates the bony structure. This weakening of the vertebral body and growing mass can put pressure on the spinal cord in rare cases, resulting in partial paralysis if not treated.
It is estimated that spinal hemangiomas occur in about ten percent of the world’s population, but less than one percent cause symptoms. In those cases, though, it is very important to receive proper treatment to maintain stability and function of the spine and legs. Fortunately, hemangiomas are not cancerous.
Treatment depends on where the tumor is located, how large it is, whether it is symptomatic and how much infiltration there is into the vertebra. The tumor can grow into the body or round solid part of the vertebra and make holes in it. The vertebra may then collapse which can damage the spinal cord and spinal nerves along with causing severe pain and dysfunction.
In this case, the hemangioma is at the 9th thoracic vertebra, and has expanded into the spinal column, pressing on the spinal cord. The plan is to remove the mass, remove the vertebra, a procedure called a corpectomy, and insert hardware and likely fuse the level above and below to ensure stability of that area of the spine.
Sometimes treatment involves embolization of the hemangioma. This treatment involves injecting a substance to stop blood flow into the mass, with the idea that reducing blood flow will reduce the size of a vascular tumor. This is not always an option. The treatment plan may involve radiation therapy in addition to surgery. This is done to prevent a recurrence, but again, whether it is appropriate depends on the specific situation.
The surgery itself also varies with the particulars of the case.