What Causes Hemangiomas of the Spine? Risk Factors, Treatment, and More

A spinal hemangioma is a noncancerous (benign) tumor that grows on the backbone. It is the most common tumor of the spine. This tumor does not cause any symptoms. Therefore, it is an asymptomatic tumor.

In rare cases, hemangiomas of the spine cause backache and numbness. A spinal hemangioma is made up of the blood vessels.

In most cases, it is diagnosed alongside some spinal issue that requires an imaging test. What causes hemangiomas of the spine? Does it have risk factors? Let’s discover more about this spinal growth.

What Are Spinal Hemangiomas?

About 33 bony structures called the vertebrae make up our spine. A spinal hemangioma is a noncancerous growth that appears as a red or purple lump on the skin, commonly in the lumbar region. The cells of the blood vessels, also called endothelial cells, form spinal hemangiomas.

This common spinal tumor does not present symptoms, due to which individuals with hemangiomas don’t require treatment.

In rare cases, the rapid division of endothelial cells forms a huge lump. This lump puts pressure on the surrounding structures, causing neurological problems and spine compression.

What Causes Hemangiomas of the Spine?

Hemangiomas are idiopathic—meaning their cause is unidentified. While the primary cause remains unclear, certain factors, such as genetics and hormones, may play a key role in causing hemangiomas of the spine.

Genetic Causes

Genetic factors play a role in the development of hemangiomas of the spine because vascular malformation is an autosomal dominant trait.

Autosomal dominant traits are expressed when one gene is necessary for the condition. This gene passes from the parent to the child with a 50/50 risk.

In autosomal dominant inheritance, one copy of the altered gene is inherited by the child. If spinal hemangiomas are linked to one such gene, an affected parent can pass off the gene to a child, predisposing them to develop spinal hemangioma.

Abnormal Vascular Growth

Since hemangiomas of the spine are vascular malformations, genetic growth factors such as gene variation and mutations could be held responsible to some extent. New blood vessels form by a process called angiogenesis.

Genetic factors such as mutations or variations in genes that regulate the vascular development process cause disorganized vessel growth in the spinal column, which forms hemangiomas of the spine.

Besides this, any problem during the development of the spine could cause hemangiomas that remain asymptomatic until adulthood.

Hormonal Influences

Hemangiomas are more common in females, which suggests hormonal influence. According to studies, the hormone estrogen contributes to hemangioma’s growth.

This also explains the occurrence of hemangiomas during pregnancy or the enlargement of preexisting vascular growths.

During pregnancy, hormone levels change, including estrogen, which impacts the formation and enlargement of hemangiomas.

Local Mechanical Factors

The lumbar spine refers to the lower back with the five largest vertebrae. The lower back receives most of the mechanical stress as it bears the body weight.

While mechanical factors don’t directly cause hemangiomas, the repetitive stress on the spine could contribute to symptoms of hemangiomas. In most cases, hemangiomas don’t present any symptoms or complications.

In adulthood, bearing significant weight on the spine, which is a common region for hemangiomas, causes pain.

Age-Related Changes

While there is ongoing research about what causes hemangiomas of the spine, some studies conclude that age-related changes could be a cause. Spinal hemangiomas are more common in women over the age of 40.

With age, degenerative conditions such as degenerative disc disease impair the blood flow to the vertebral structures. Altered blood flow affects vascular growth in the spine, causing hemangiomas. These changes may also result in the enlargement of existing hemangiomas.

Risk Factors for Spinal Hemangiomas

While benign, noncancerous hemangiomas present no symptoms, the symptomatic hemangiomas make up 1% of all hemangiomas. If left untreated, they can cause neurological issues. Risk factors include the following.

• Age: High prevalence in people aged 40 and above
• Gender: More common in women
• Family history: Genetics play a role in vascular malformations
• Medical history: Other vascular malformations put you at an increased risk for hemangiomas

Most of these risk factors are not modifiable. Since 1% of symptomatic spinal hemangioma occurs, it’s important to recognize the symptoms for prompt treatment.

Symptoms of Hemangiomas of the Spine

Symptoms of spinal hemangiomas include:

• Back pain
• Numbness
• Nerve compression
• Radicular pain
• Bowel and bladder dysfunction
• A tingling sensation in the lower back

Complications of a Spinal Hemangioma

What causes hemangiomas of the spine is often related to the diverse complications it presents. For example, most genetic factors at play do not cause complications such as bone fractures.

However, if vascular malformations enlarge the hemangiomas, they affect the spine and cause complications.

Some painful complications include:

• Bone displacement
• Spinal canal erosion
• Bone fractures
• Hematoma
• Nerve compression
• Severe lower back pain
• Restricted movement

Treatment for Spinal Hemangiomas

The treatment methods for hemangiomas of the spine depend on how severe the symptoms are. Some factors influence the treatment options. These include the size of the hemangioma, its location, and whether it is symptomatic or asymptomatic.

Radiation Therapy

The most common line of treatment for the hemangiomas of the spine is radiation therapy. If the hemangiomas cause neurological symptoms, the radiation is targeted to the growth to shrink it.

Reducing the size of the hemangiomas relieves pressure on the surrounding structures, such as nerves, vertebrae, and muscles. This is a non-invasive method that works well in cases where surgery poses risks.

Endovascular Embolization

Endovascular embolization of the spinal hemangioma refers to a process that blocks the blood flow to the tumor.

A catheter injects materials into the blood vessels that supply the tumor. Once the blood supply is cut off, the hemangioma shrinks.

Surgery

Large hemangiomas of the spine push against the adjacent structures, causing pain. They also compress the nerves and lead to spinal instability. In such cases, surgical intervention is needed to completely remove the hemangioma.

Vertebrectomy is a type of surgery that removes the affected vertebra. The risks of surgery include excessive bleeding, artery damage, blood clotting, and infection. Therefore, surgical intervention is reserved for rare cases where other treatments prove ineffective.

Final Words

There isn’t a definite way to prevent hemangioma, as the known causes are unmodifiable. Most cases of hemangiomas of the spine remain asymptomatic.

They only get diagnosed as a result of screening for some unrelated reason. Therefore, hemangioma is not a threat to your well-being.

However, if you notice back pain, a lump in your spine, or other associated problems, consult a doctor for diagnosis and treatment. The advanced treatment options can effectively address symptomatic and asymptomatic hemangioma of the spine.