What Is a Vertebral Haemangioma, and Is It Dangerous?
A vertebral haemangioma is a benign (non-cancerous) collection of blood vessels inside a spinal bone. It is one of the most common incidental findings on spine imaging and is almost always harmless. Most people never know they have one, and the vast majority need no treatment at all.
Key takeaways
- Vertebral haemangiomas are found in up to 10% of spine scans and are almost always harmless.
- They are usually discovered by accident when you have a scan for something else.
- The vast majority cause no symptoms and need no treatment.
- A very small number are classified as "aggressive" and may need specialist review.
- If you have new numbness, weakness or bladder changes, seek urgent medical attention.
What exactly is a vertebral haemangioma?
A vertebral haemangioma is a small tangle of blood vessels that forms inside the body of a vertebra (one of the bones that make up your spine). It is a benign vascular lesion, meaning it is not cancer and it does not spread to other parts of the body.
Think of it like a tiny cluster of extra blood vessels woven into the spongy interior of a spinal bone. They develop slowly, often over many years, and in most people they stay small and completely silent.
Vertebral haemangiomas are remarkably common. Studies suggest they are present in roughly 10% of spine MRI scans. Most are picked up as an incidental finding, meaning the scan was done for a completely different reason, such as investigating back pain, and the haemangioma was spotted along the way.
Does a vertebral haemangioma cause symptoms?
In the vast majority of cases, no. Most vertebral haemangiomas are completely asymptomatic. You cannot feel them, and they do not cause pain.
The overwhelming majority of haemangiomas cause no pain whatsoever. If your scan mentions one, it is very likely unrelated to the symptoms you are being investigated for.
They are typically noted on a scan report as a side observation. Your radiologist may describe it as "an incidental finding of no clinical significance."
In very rare cases, a large or "aggressive" haemangioma may expand into the spinal canal and press on nerves. This can cause localised pain, tingling or weakness.
If your scan report mentions a vertebral haemangioma and you have no new neurological symptoms (numbness, weakness, bladder or bowel changes), you can almost certainly take reassurance from the finding. It is overwhelmingly likely to be harmless.
What is the difference between a typical and an aggressive haemangioma?
Radiologists generally group vertebral haemangiomas into two categories based on how they look on imaging. The distinction matters because it guides whether any follow-up is needed.
- Small, contained within the vertebral body
- Has a characteristic "polka dot" look on imaging
- Completely asymptomatic
- Needs no treatment and no follow-up
- Makes up the vast majority of cases
- Larger and may extend beyond the bone
- Can press on the spinal cord or nerve roots
- May cause pain, numbness or weakness
- Usually needs specialist assessment
- Accounts for a very small fraction of all haemangiomas
Your scan report will typically describe the appearance in enough detail for your doctor to tell whether it falls into the typical or aggressive category. If you are uncertain, ask your GP or the reporting radiologist for clarification.
How is a vertebral haemangioma found?
Almost all vertebral haemangiomas are discovered as an incidental finding on spine MRI. MRI is particularly good at picking them up because of the way the blood vessels within the lesion appear on different scan sequences. They can also be seen on CT scans and occasionally on a full spine x-ray, though MRI provides the most detail.
A note on imaging types. MRI is excellent for identifying and characterising soft-tissue structures, including haemangiomas, discs and nerves. EOS and standing x-rays, such as those offered by ScanAlign standing EOS imaging, are designed to show bones, joints and whole-body alignment under gravity. Each type of imaging answers a different clinical question, and they complement each other well.
Because a haemangioma sits inside the bone, it does not affect your posture or alignment. If you were having imaging for back pain and a haemangioma was noted, your clinician will usually focus on the other findings (such as disc or alignment issues) as the more likely explanation for your symptoms.
Does a vertebral haemangioma need treatment?
The short answer for most people is no. A typical, asymptomatic vertebral haemangioma is a benign spine lesion that does not require any treatment, monitoring or lifestyle changes. You can exercise, lift, stretch and carry on with daily life as normal.
There is no evidence that a typical haemangioma will grow, become cancerous, or cause problems in the future. Most clinicians will not even mention it at follow-up appointments because it is considered a normal variant.
In the very rare situation where a haemangioma is classified as aggressive and is causing nerve compression symptoms, a specialist may consider intervention. This would always be managed by a spinal or neurosurgical team, not by a diagnostic imaging clinic. If you are unsure whether your findings warrant a referral, read our guide on when to see a specialist.
When should you worry about a spinal haemangioma?
For the vast majority of people, you should not worry at all. A typical vertebral haemangioma is one of the most benign findings possible on a spine scan. It is not a tumour that will spread, and it will not weaken your spine.
However, you should seek urgent medical attention (your GP, NHS 111, or A&E) if you develop any of the following, regardless of what your scan shows:
- New or worsening numbness or tingling in your legs or arms
- Weakness in your legs that makes walking difficult
- Loss of bladder or bowel control
- Sudden, severe back pain that is very different from your usual symptoms
These symptoms can have many causes and are not specific to haemangiomas. They always warrant prompt medical assessment.
If your back pain is ongoing and previous scans have not given clear answers, a standing assessment can sometimes reveal alignment problems that lying-down imaging misses. Speak to our team to find out whether it could help.
Book a free video consultationFrequently asked questions about vertebral haemangiomas
No. A vertebral haemangioma is a benign (non-cancerous) collection of blood vessels. It does not spread, and it is not related to bone cancer or metastatic disease.
Typical haemangiomas do not cause pain. If you have back pain and an incidental haemangioma on your scan, the pain is almost certainly coming from something else, such as a disc, joint or alignment issue.
Very common. Studies suggest they appear in roughly 10% of all spine MRI scans. Many more people likely have them without ever having a scan.
For a typical, asymptomatic haemangioma, no follow-up is needed. If the radiologist describes it as atypical or aggressive, your doctor may recommend further imaging or a specialist opinion.
Most remain stable for life. In rare cases an aggressive haemangioma may enlarge slowly, but this is uncommon and would usually be picked up on routine imaging if you are being monitored for another reason.
No. A typical haemangioma does not affect the strength of your spine. You can exercise, lift weights and stay active as you normally would.
On MRI, a typical haemangioma appears bright on certain sequences because of the fat and blood vessel content. On CT, it often shows a characteristic "polka dot" pattern caused by thickened bone struts. These appearances are distinctive enough that further testing is rarely needed.
Yes. It is not unusual to have haemangiomas in more than one vertebra. Multiple typical haemangiomas are still considered benign and generally need no treatment.
EOS imaging is designed to assess bones, joints and whole-body alignment rather than the internal structure of individual vertebrae. MRI is the best tool for identifying and characterising haemangiomas. If you also have alignment or postural concerns, a standing scan can provide complementary information.
At ScanAlign, you do not need a GP referral. You can book a standing spine scan directly. For MRI, most private providers also accept self-referrals, though some may prefer a clinical letter.
Have questions about your spine scan findings?
If your back pain has not been fully explained by previous imaging, a free video consultation can help you understand whether a standing alignment assessment is right for you.
Book a free video consultationWritten by
Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- Rodallec MH, Feydy A, Larousserie F, et al. Diagnostic imaging of solitary tumors of the spine: what to do and say. RadioGraphics. 2008;28(4):1019-1041.
- Murphey MD, Fairbairn KJ, Parman LM, et al. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. RadioGraphics. 1995;15(4):893-917.
- NHS. Back pain: causes, treatment and when to see a GP. nhs.uk/conditions/back-pain.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.