Back pain and vertebral hemangioma

Abstract

Back pain is the most common reason for seeking medical help. The authors analyzed the medical documentation of 6,619 patients (mean age 60.5 years) with back pain. In 97.5% of patients the causes of back pain were degenerative-dystrophic processes of the spine. Vertebral hemangioma as the main and only cause of pain (symptomatic hemangioma) wasn’t observed at all. In 189 (2.9%) patients, an asymptomatic vertebral hemangioma was diagnosed by chance: in x-rays - in 45 (23.8%) patients, computed tomography or magnetic resonance imaging of the spine - in 144 (76.2%) patients. In 76.2% of cases the hemangioma occurred in patients with osteochondrosis of the spine, and in 77.1% of cases also with a hernia and/or disc protrusion. The location of the vertebral hemangioma corresponded to the level of the hernia/disc protrusion in 36.5% of patients. Based on clinical, radiological and magnetic resonance studies and taking into account the absolute signs of aggressiveness, nonaggressive vertebral hemangioma was diagnosed in 186 (98.4%) patients, of which 0.8% patients had a multiple form, and aggressive hemangioma - in 3 (1,6%) patients. Analysis showed that the treatment tactics of patients with back pain should include computed tomography and/or magnetic resonance imaging, even in the absence of hemangioma in spinal x-ray. Patients with aggressive vertebral hemangioma are subject of surgical treatment. There are currently no studies on the use of physical methods on patients with back pain in combination with a nonaggressive vertebral hemangioma that limits the access of such patients to a full-fledged treatment and significantly reduces the effectiveness of rehabilitation.