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Neurology (Expert Forum)
Verterbral Hemangioma/Back pain
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Verterbral Hemangioma/Back pain
by Smart1, Apr 04, 2004 12:00AM
I am a 36 y.o L&D RN. I dismissed my low back pain as "bending over too many patient beds". My pain is when I am trying to get from a sitting position to a standing position. Once I am up straight, I am fine for the most part. On really bad days, I have pain no matter what. I had a normal X-ray, proceded with Chiropractor, then had an MRI 1 year ago. It showed mild degenerative facet arthropathy with small disc protrusion at T12-L1. The remainder is normal with incidental note of probable hemangioma of L3(1.2cm). I tried Motrin, Celebrex and deep tissue massage. The neurosurgeon said there was nothing to fix, people have pain when they get old and sent me away with some Ultram. I went to a Spine doctor who has tried Flexoril, Medrol, Lidoderm, and Topamax. I also progressed from Ultram to Darvocet to Lortab. A bending X-ray showed no evidence of listhesis, disc narrowing or any acute process, mild degenerative arthritic changes of facets L4-5 and L5-S1. I had injections into the facets to numb the nerves & relieve the pain. This did not work. I tried Physical Therapy. I insisted on a repeat MRI - it showed a 1.5cm lesion in L3 "Benign hemangioma is probably still a possibility but the T1 signal characteristics do not confirm benign hemangioma" and follow-up is recommended with high resolution CT. Also a sub-cm benign hemangioma in the S1 sacral segment and on L1. No disc herniation, nerve root encroachment or spinal stenosis. CT scan showed sclerosis of the vertebral bodies T12, L1 and L4. What test do I need? Who do I see? Can my hemangiomas cause pain?
Doctor's Answer
by CCF-Neuro-M.D.-CS, Apr 07, 2004 12:00AM
Hemangiomas of the spine should not cause pain. I suspect that the degenerative changes noted, are the culprit. What I would recommend is for you to have an opinion at a large acdemic spine center. If you are in the area we have a great group of doctors. They will be able to examine you, review the films, and make further diagnostic and treatment recommendations. I wish I could be of more help, but without seeing the films and examining you I can not make any other recommendations. Good luck
