Question
Hi, follow up information from question dated 26/5/10. I visited the neurosurgeon only to be told he didn't have my scans, so I have to return again at a later date.

The reason I am writing though is to tell you what he said about the hemangioma. He said that they are found as an incidental on the scan and they don't cause any problems and loads of people have them with no problems, which to me sounds like he is dismissing the tumor altogether.

I also wanted your advice on how to approach the consultant to get something done about this, either monitoring or removing because in England we have the NHS service which is limited and I cannot afford to pay to go private.

Thank you in advance

Carol Entwistle

Answer
Hello again Carol,
Nice to hear back from you. This is a quote of part of a previous answer I gave you in response to your question about hemangiomas:

"Vertebral or spinal hemangioma are quite common, in fact they occur in approximately 10-12 percent of the population and are discovered incidentally, and are usually considered to be a benign tumour (non-cancerous)"

So, from a statistical standpoint a hemangioma usually does not cause problems.
As for how to approach your consultant as how to get something done about it - if I wanted to look deeper I would simply ask the doctor to suggest and create an approach to watch the hemangioma closer and I would ask him to discuss the possibility of removing it. Ask him if monitoring it would include a biopsy and/or a bone scan or not. It's always a good idea to get clear answers including pros and cons of following through with an option vs not following through with any specific option.

With regards to the question of removing the hemangioma or not I would want to know the risks of such a procedure - such as creating greater spinal instability as a result of the procedure, recovery time, as well as benefits of proceeding with such a procedure, and general surgical risks. Would such a procedure require a fusion, and if so would that hasten the development of adjacent spinal disc problems or facet spine problems.

I hope this helped you Carol.
As usual keep me posted and kindly rank my response.

Dr. Ron Nusbaum
www.backclinicsofcanada.ca