Vertebral Hemangioma

What it is

A vertebral hemangioma is a benign (non-cancerous) tangle of blood vessels inside a spine bone. They are very common, become more frequent with age, and are usually found by accident on an MRI or CT done for some other reason. In the large majority of people they cause no symptoms at all and never need treatment.

What it feels like

Almost always, nothing — a typical hemangioma is silent and harmless. Rarely, a more active (“aggressive”) hemangioma grows enough to cause local back pain, or, very uncommonly, to press on nearby nerves or the spinal cord. Those rare cases are the exception, not the rule.

How we evaluate it

On MRI and CT, a typical hemangioma has a characteristic, reassuring appearance that lets me recognize it confidently as benign. When the appearance is typical and you have no related symptoms, no further workup is needed — the main job is to confirm it is the harmless kind and set your mind at ease.

How we treat it

The usual treatment is no treatment — just reassurance, and occasionally a follow-up image if anything is atypical. For the rare hemangioma that causes real pain or presses on the nervous system, options include a targeted procedure (such as injecting cement or blocking the vessels) or, uncommonly, surgery. For the typical incidental finding, none of that applies.

The science — for the curious

It is worth saying plainly: finding a hemangioma on your scan is usually good news disguised as a scary word. These are among the most common incidental findings in the spine, and recognizing the typical pattern is what lets me reassure you without a cascade of further testing. Only the unusual, symptomatic hemangioma needs anything done — and that is rare.

Learn more

American Cancer Society — Spinal Tumors: cancer.org

Johns Hopkins Medicine — Spinal Tumors: hopkinsmedicine.org

This handout is general education about a common condition and does not replace the personalized advice we discuss in clinic. If anything here does not match what we talked about, what we talked about wins — please ask me.