Vertebral Hemangioma

[Rich1]

I am a physician and have been out of work for over 5 years with intractable neck pain. I have a Vertebral Hemangioma at the T-1 area that fills over %50 of the vertebral body but every physician tells me not to consider it a pain source. I have neck pain but it is much worse when sitting or standing. I cannot sit more that ten minutes at a time.  I have heard of ethanol treatments.  Can you give me some advice or would you consider a visit and evaluation?  Dr. Lacy

[able]

what exactly is this hemagioma?  Just recently went for updated MRI from last year and this was part of my changing condition..It states diffuse signal changes in the bone marrow consistant with fatty changes, perhaps benign hemanioma no aggressive character.  This is along with herniations to c3-4, c4-5, bulging disks at c5-6, c6-7, severe degenerative changes from c-3 to c-7 with large spurs to the anterior of the vertebral wall, severe kyphosis, significant signal change from c-3 to c-7 of the spinal canal with a deformity to spinal cord.  Trauma induced.

[CRISTINA1966]

A related discussion,   vertebral hemangioma was started.

[connie291]

A related discussion, Hemangioma was started.

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

Sorry to hear about your symptoms.  Neck pain in the absence of a radiculopathy, weakness, or corticospinal tract findings would be an unlikely presentation of a vertebral hemangioma. I'm guessing it was probably an incidental finding on an MRI. The ethanol treatments are usually reserved for people with intractable symptomatic hemangiomas as they carry risks of complications that can be quite dramatic such as spinal cord infarction.  As you know, ethanol can be directly injected into the hemangioma percutaneously to sclerose it or into the feeding vessels. There's always a possibility that the feeding vessels may also supply part of the spinal cord which could lead to disastrous results if  a sclerosing agent is injected. The alternative of direct injection appears to be safer.  But every procedure carries risks.  And if the hemangioma is not the source of pain, then you would end up with risks but no benefit.For more info, there is a great review article in the New England Journal of Medicine from Aug 1994 that you can read and make your own decision.

It might help to get a second opinion on your neck pain. Perhaps a fresh look by a neurologist or even pain clinic can get you back to work soon. Best of luck.