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URL http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15855908
Journal J Manipulative Physiol Ther. 2005 Mar-apr;28(3):194-198
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Peer Review Yes
Publication Type Case Report
Abstract/Notes OBJECTIVE: To present a case of symptomatic, expansile L1 vertebral hemangioma.

CLINICAL FEATURES: A 46-year-old man presented with progressive neurologic changes and insidious onset of low back pain.

INTERVENTION AND OUTCOME: After a trial of 3 visits of conservative chiropractic care, no improvement was noted. Magnetic resonance imaging was obtained, revealing an expansile hemangioma with extra-osseous component compromising the conus medullaris at the level of the L1 lumbar vertebra. Neurosurgical intervention resulted in clinical improvement.

CONCLUSION: Primary care physicians treating patients with low back pain should be aware of neurologic red flags requiring prompt attention. Magnetic resonance imaging is the imaging modality of choice when evaluating a neurologic abnormality presumably related to a space-occupying lesion. Although a disk herniation is the most common cause of these symptoms, clues in the history and examination must prompt physicians to expand their differential diagnosis to include a variety of other extradural masses.

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