Lumbar vertebral hemangioma mimicking lateral spinal canal stenosis: case report and review of literature

J Spinal Cord Med. 2014 Mar;37(2):237-42. doi: 10.1179/2045772313Y.0000000135. Epub 2013 Nov 26.

Abstract

Context Hemangiomas are the commonest benign tumors of the spine. Most occur in the thoracolumbar spine and the majority are asymptomatic. Rarely, hemangiomas cause symptoms through epidural expansion of the involved vertebra, resulting in spinal canal stenosis, spontaneous epidural hemorrhage, and pathological burst fracture. Findings We report a rare case of a 73-year-old woman, who had been treated for two months for degenerative neurogenic claudication. On admission, magnetic resonance imaging and computed tomographic scans revealed a hemangioma of the third lumbar vertebra protruding to the epidural space producing lateral spinal stenosis and ipsilateral nerve root compression. The patient underwent successful right hemilaminectomy for decompression of the nerve root, balloon kyphoplasty with poly-methyl methacrylate (PMMA) and pedicle screw segmental stabilization. Postoperative course was uneventful. Conclusion In the elderly, this rare presentation of spinal stenosis due to hemangiomas may be encountered. Decompression and vertebral augmentation by means balloon kyphoplasty with PMMA plus segmental pedicle screw fixation is recommended.

Keywords: Balloon Kyphoplasty; Root compression; Spinal canal stenosis; Vertebra hemangioma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Female
  • Hemangioma / diagnosis*
  • Hemangioma / diagnostic imaging
  • Humans
  • Kyphoplasty
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery
  • Magnetic Resonance Imaging
  • Multimodal Imaging
  • Spinal Cord Neoplasms / diagnosis*
  • Spinal Cord Neoplasms / diagnostic imaging
  • Spinal Stenosis / diagnosis*
  • Spinal Stenosis / diagnostic imaging
  • Spinal Stenosis / surgery
  • Tomography, X-Ray Computed