Background: Hemangiomas are the commonest benign tumors to be encountered in the vertebra with a reported incidence of 10-27%. Pregnancy even though has been known to be an important risk factor for progression of these lesions (often symptomatic), very few of them (less than 30) have been reported in literature. The management of which still remains controversial.
Case Description: A 30 years old women in the 26th week of gestation presented with acute onset of upper back pain and progressive paraparesis. Imaging studies correlated with a large hemangioma at T-9 which involved the body, pedicles and the transverse process with extradural extension of the soft tissue component. In view of the precious pregnancy she was kept under observation till the completion of 32 weeks of gestation at which an elective cesarean section was completed and the patient was taken up for decompression and fusion with instrumentation after prior embolization of the lesion at the 1st week postpartum. The patient gradually recovered from the neurological deficits. At the last follow-up, 2 years from the surgery the patient continues to remain symptom free with full neurological recovery.
Conclusion: The management of symptomatic vertebral hemangiomas in pregnancy continues to be a matter of debate. Based on review of literature and our case report, the accepted norm of delaying the surgical management till the fetus achieves a viable status can still be adopted with good results.
vertebral hemangioma, pregnancy related hemangiomas, postpartum surgery hemangioma