Spinal Hemangioma

[johnston]

I have been diagnosed with a benign vertebral hemangioma on C7 that is 7mm. I have sharp throbbing pain that starts between my shoulder blades and shoots into both arms. I have been to an oncologist, and a neurosurgeon. The neurosurgeon said to do nothing but "watch" it, and repeat the MRI in 6 months. I wouldn't be opposed to that, except that I have so much pain.  It is becoming unbearable and I have been on high doses of hydrocodone for the last 5 weeks.

In order to diagnose this, I have undergone a CT Scan, Bone Scan, and MRI.  

I have researched hemangioma extensively and have yet to find anything about this type of tumor being located in the cervical vertebrae.

What is the typical treatment for this?  Although this tumor seems small, I believe it is the cause for the pain.  Do you also believe that something so small could cause so much pain?  I have been getting nowhere with the doctors in my area and am ready to go over 400 miles away to get help.  Do you think this is necessary or should I just give up and hope the pain subsides in the next six months?

Any help would be greatly appreciated as I am losing patience.

Thanks,

JJ

[CCF-Neuro-M.D.-CS]

Vertebral hemangiomas are benign lesions of the spine. The thoracic and lumbar regions are the most common locations for these lesions, however they can be found within the cervical spine. In order for this lesion to cause your pain there usually is a compression fracture associated with it, or there is compression on the spinal cord. If you are questioning the diagnosis and treatment plan, then I think it is a good idea to get a second opinion. I would recommend being seen at a Spine Center, such as the one at the Cleveland Clinic, for a second opinion.

[johnston]

I wanted to add that I have also lost strength in both arms and hands.  I now have to use both hands to pick up a gallon of milk without dropping it or spilling it.  I can't lift my kids and this is greatly affecting my day to day life.  

Thanks again.

[mnguy]

I have a vertebral hemangioma, but a bit lower, T3. I was a bit more fortunate, in that it wasn't causing pain, but numbness. It began in my toes and progressed up my legs, into the abdominal area. It's amazing how it can zap your strength. By the time I had surgery, I could barely walk. The surgery however, has been successful - there is residual numbness in my toes, but that's about all. My thoughts and prayers are with you. Good luck!

[johnston]

mnguy:

What type of surgery did you have?  Was it a long process to get to the point of surgery?  I feel like I have been getting the run around from all my doctors, and I live in an area that doesn't have the best doctors.  (We only have 2 neurosurgeons total!)

Any information would be greatly appreciated.

JJ

[mnguy]

I actually had surgery twice. The first surgery was a laminectomy (T2-T4) in 1998, performed to decompress the spinal cord. The hemangioma had been in T3, and the surgery was followed by a vertebroplasty(sp?) where the voids left in the vertebra were injected with a plastic, so it wouldn't collapse.
The hemangioma continued to grow, though, and the surgery was repeated in 2001. The intent had been to remove the vertebra and reconstruct it. That wasn't possible due to complications, so they did further decompression of the spinal cord and followed that with radiation treatments. Latest MRI showed no change since the surgery, which was very good news.
The waiting wasn't very long either time. At the time of my first surgery, I was deteriorating rapidly, so the surgeons did whatever they could to get me on their schedule. Fortunately there are a number of excellent neurosurgeons in the Minneapolis area.
I wish you the best.

[MEL55]

I have a question about the hemangioma. I have one in the T9-10 area. I was told there was no reason to worry about it. Is there some specific problem from this. I so have pain in the area all the time. Thanks, MEL55

[johnston]

MEL55:
I am having the same trouble.  Every doctor I go to tells me that this should not cause pain.  But....it does.  Only mine radiates into both arms because of where it is.  You should do some research to find out what nerves could be affected by a tumor in this area, especially if you start having referred pain (down your legs for example).  There is a multitude of information on the net, however if you type in hemangioma in a search engine, you mostly get infomation on the skin hemangioma.  Try spinal hemangioma.  I hope you have better luck than I have had so far.  Mine started about 2 and a half months ago, and I am still on extremely strong painkillers.  I am also having to go to a neurosurgeon 3 hours away.  Good Luck.  If you need more information I will be happy to tell you what I have learned.  Post your email address and I will email you.

JJ

[Becky100]

I have been in alot of pain since July 3, 2003.  They just discovered two weeks ago from an MRI that I had done that I have a Hemangioma at the C-6 in my Neck.  I am in so much pain in my left arm.  Trying to find information about this condition is like looking for a needle in a haystack.  I am to the point of asking for a pain pill to try and help to decrease the pain some until they come to a decision about this problem.  I would like to find someone who has information about this problem.  If there is anyone I can talk to I would appreciate it.  Right now I have to go because the pain is to much just sitting at the computer.  Thank you for any information anyone can give me.

Becky

[singingrep]

A hemangioma is a benign tumor of the blood vessels.  Benign means that is has no malignant potential, therefore they usually do not cause any problems.  Sometimes they are problematic.  In your case you are loosing function of both your arms as evident by the fact that it takes both your arms to lift a gallon of milk.  It is time for a more detailed examination by a reconstructive neurosurgeon.  The surgery is extremely complicated since they have to remove a tumor of blood vessels which bleeds profusely and reconstruct or fuse your neck at that level.  They usually harvest bone from a cadaver and your own hips to reconstruct the spine.  You are going to lose some motion of your neck when they fuse your spine.  I have seen blood loss of up to 4 units with this surgery, so you might want to donate several pints of your own blood prior to surgery so they have it avaliable in case you need it. The surgery is not without risk, and I usually advise my patients to delay as long as possible or at least until they are symptomatic.  You are symptomatic so it is time for a second opinion.  I would advise a second opinion from a place that specializes in spine problems.  I think a neurosurgeon would be more appropriate than an orthopedic surgeon to evaluate this.  Dr. Johnson

[singingrep]

A hemangioma is a benign tumor of the blood vessels.  Benign means that is has no malignant potential, therefore they usually do not cause any problems.  Sometimes they are problematic.  In your case you are loosing function of both your arms as evident by the fact that it takes both your arms to lift a gallon of milk.  It is time for a more detailed examination by a reconstructive neurosurgeon.  The surgery is extremely complicated since they have to remove a tumor of blood vessels which bleeds profusely and reconstruct or fuse your neck at that level.  They usually harvest bone from a cadaver and your own hips to reconstruct the spine.  You are going to lose some motion of your neck when they fuse your spine.  I have seen blood loss of up to 4 units with this surgery, so you might want to donate several pints of your own blood prior to surgery so they have it avaliable in case you need it. The surgery is not without risk, and I usually advise my patients to delay as long as possible or at least until they are symptomatic.  You are symptomatic so it is time for a second opinion.  I would advise a second opinion from a place that specializes in spine problems.  I think a neurosurgeon would be more appropriate than an orthopedic surgeon to evaluate this.  Dr. Johnson

[singingrep]

A hemangioma is a benign tumor of the blood vessels.  Benign means that is has no malignant potential, therefore they usually do not cause any problems.  Sometimes they are problematic.  In your case you are loosing function of both your arms as evident by the fact that it takes both your arms to lift a gallon of milk.  It is time for a more detailed examination by a reconstructive neurosurgeon.  The surgery is extremely complicated since they have to remove a tumor of blood vessels which bleeds profusely and reconstruct or fuse your neck at that level.  They usually harvest bone from a cadaver and your own hips to reconstruct the spine.  You are going to lose some motion of your neck when they fuse your spine.  I have seen blood loss of up to 4 units with this surgery, so you might want to donate several pints of your own blood prior to surgery so they have it avaliable in case you need it. The surgery is not without risk, and I usually advise my patients to delay as long as possible or at least until they are symptomatic.  You are symptomatic so it is time for a second opinion.  I would advise a second opinion from a place that specializes in spine problems.  I think a neurosurgeon would be more appropriate than an orthopedic surgeon to evaluate this.  Dr. Johnson

[johnston]

Dr. Johnson,

I have since been to a neurosurgeon in Dallas, Texas.  He told me that the hemangioma is an "incidental finding" and that something else is causing the pain.  I have, however, gotten a copy of my MRI report.  It shows that I have "minimal left sided neural foraminal narrowing".  When I questioned him about it, he said that it wasn't bad enough to risk surgery to reduce the narrowing.  He referred me back to my oncologist, who has already determined it isn't cancer.  

So....I have been sent to a pain management doctor who specializes in non-surgical treatment of spinal disorders.  After all but calling me a drug addict (which really made me angry) she tried to tell me that I just have muscle problems.  I have been through two weeks of physical therapy, including traction, which has not helped at all.  I am now experiencing a "burning pain" in my arms, and I'm not sure who to talk to about it.  I am beginning to feel worse, and I am no longer on the pain medication.  All I have is a muscle relaxer that I can't take during the daytime.  Do you think the therapy is actually making me worse?  Or could it even do that?

Any further help that you or anyone else can provide will be greatly appreciated.  Oh...what kind of doctor are you, just out of curiousity?

Thanks,

JJ

[Becky100]

Just an update on my condition.  Instead of one hemangioma at the C-6 I am now told that I have hemangiomas at the T-1 and the T-2.  Still in a lot of pain.  I am sch to see a pain doctor on the 26th of September.  I hope he can be of some help to me as I am not getting the help from the family doctor.  My daughter who has worked in the medical field told me that the surgery is somewhat complicated and she said to hold off on the surgery as long as possible.  I hope the pain doctor can help me as I have been in pain since July the 3rd and it is getting real difficult living with this pain.  Any suggestion from anyone would be of great importance to me.

Becky

[Grace121]

I am not a doctor, but from personal experience with severe spinal/back and other pain, it is often necessary to take drugs for long-term pain to have a liveable life, whether or not certain doctors have issues with assumptions of drug addiction.  It's a matter of finding the right doctor who understands this.  From my personal dealings with a pain level that I could not begin to measure, the best meds are those such as MS Contin, Oxycontin or the Duragesic patch.  These medications are strong, but release specific amounts of the drug into the bloodstream for 12 hour (or longer) periods of time.  They help manage severe pain without a person in chronic pain having to be worried or concerned about "when they can take the next pill" (maybe helpful in avoiding possible potential addiction concerns - although many doctors seem not to know that people who suffer chronic pain are not as likely as short term pain sufferers to become addicted to pain meds).  Again, you have to find a good doctor who understands this and the fact that you just can't live with constant pain - they are out there; it just may take some time to find them, as it may unfortunately take time to find a doctor who will understand exactly what is going on with you and maybe concur with what you already know yourself or suspect is happening in your body based on the info you've been given.  One last thing that I accidentally came across (not even from a doctor but by research) is something called a "Lidoderm patch".  It has helped me greatly and is not a narcotic or painkiller, but a local anesthetic patch that can be applied to areas of pain on the body that are more specific or focused in a particular area (not for general pain).  It is the only thing of its kind available as an FDA-approved prescription. I hope someone is helped by this.

[Coho]

I have had 2 major pains going on in the last 1 1/2 yrs. After numerous tests x-rays showed I have a displace #8 right rib. But in the last 6 mths. I've developed back pain mainly in the mid-thoracic spinal region. An MRI in July,2003 showed small disk protrusions at T6-7 and T8-9 plus a benign hemangioma at T10 that looks like it takes up the entire vertebrae. I have a very physical outdoor job and in the last 2 mths. the pain especially at the end of the day has been excruciating. It's hard to catch my breathe sometimes because of the pain. Alot of burning in the center of my back especially when bending at certain angles. The pain now radiates towards the left side of my back plus by mid day, during work, if I lean my back on a chair or car seat I get incredible pressure like someone is standing on my back. I had a spinal shot for pain in Sept. which did not help. The pain Doctor said what the MRI shows shouldn't be causing all this pain. I currently have an apt. with my Neurosurgeon in 2 weeks. The pain is probably around a 3 when I'm off but at work goes up to a 10. Could the hemangioma be causing such pain since the description of the disk protrusions don't sound so bad? I hope the Doctor can help me, it's impossible to make it through a day of work without being near tears.

[flirt]

I am so glad that I am not the only one with this problem. I was just diagnosed with a T6 and T11 "small" hemangioma. I am going to be sent to a spinal specialist for further testing. I am currently using a duragesic patch and other pain meds for "break-
through" pain. I was also told by a NP that this pain is "all
psychological" in nature. I get to the point that I cannot breathe related to the pain. I also get the "look" that I am drug
seeking. I am a nurse and my patients are not going to be in pain
on my shift, if I can help it. Thank you all for listening to me
I acutually feel that there may be help out there.

[Bharathi]

My husband is 58 years, Surgical Oncologist from India. He is suffering Hemangioma of Spine at D10 and L3 and it is occupying 80% of L3 Vertebral body. He has severe back pain from 5-7 yeards and could not perform day to day activities. Recent MRI shows Hemangioma. Earlier in 1975 he underwent posterior spinal fusion for Caries spine for D10, 11 and 12. Now he is having severe pain more in the mornings, hands breadth above gluteal region.

Please let us know if you have any info on this. You could reach me via email at "***@****" or at 678-361-1200.

Thanks,
Bharathi

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