Incidental vertebral lesions

Coumans, Jean-Valéry; Walcott, Brian P.

doi:10.3171/2011.9.focus11207

Cited by 6 publications

(5 citation statements)

References 59 publications

(67 reference statements)

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“…Although the suspicion of spinal pathology, usually disc in origin, is the reason for the radiologic study, there is a relatively large anatomic area surrounding the lumbar spine where there can be numerous extraspinal lesions in the abdomen and retroperitoneal space including the kidneys, aorta, vena cava and iliac vessels as well as pelvic structures, the pre- and paravertebral space, and paraspinal soft tissue and muscles [ 3 , 4 ]. Incidental spinal lesions are divided into intraosseous vertebral spinal lesions identified within the actual vertebrae or disc space distinguishing them from intraspinal lesions [ 5 - 7 ]. The vertebrae are the most common location for incidental findings, comprising 70–80% of incidental spine lesions and commonly include hemangiomas, unsuspected osteoporotic fractures, intraosseous tumors, and unsuspected spinal metastasis [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Incidental spinal lesions not related to the original reason for the radiologic study being performed are further classified as vertebral or intraspinal. Unsuspected lesions within the vertebrae are commonly hemangiomas, osteoporotic fractures at the lumbar and lumbar-thoracic levels and bony and metastatic tumors [ 3 - 5 ]. Intraspinal lesions include Tarlov cysts, lipomas, tethered cord and rarely intraspinal tumors as in these two cases.…”

Section: Introductionmentioning

confidence: 99%

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Two Cases with Incidental Finding of Large Asymptomatic Intradural Lumbar Tumors

Hartman

Granville

Jacobson

2018

Cureus

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Benign lumbar intradural tumors are statistically uncommon and usually present with complaints of back pain with or without radicular neurological complaints. This report involves two separate patients that were found incidentally to have large intradural tumors without any neurologic complaints. In both cases the tumors were discovered when having magnetic resonance imaging (MRI) after minor auto accidents. Neither patient had any pre-existing lumbar or neurologic complaints. The report will review the different regions and types of incidental findings commonly seen on lumbar MRI scans and the need for close follow-up in patients with incidental lesions such as tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Two Cases with Incidental Finding of Large Asymptomatic Intradural Lumbar Tumors

Hartman

Granville

Jacobson

2018

Cureus

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“…Degenerative changes and spondylosis are particularly prevalent on imaging, although these incidental findings are far more common in adults [22]. In the pediatric population, common incidental findings include scoliosis, vertebral hemangiomas, congenital fusion, abnormal segmentation, os odontoideum, and spina bifida occulta [15]. Radiologists reviewing spinal MRIs are recommended to evaluate for extraspinal incidental findings, including thyroglossal duct cysts, hepatic masses, lung nodules, and renal cysts, given that they occur at a nontrivial rate and early detection can significantly improve outcomes [23].…”

Section: Isolated Incidental Intradural Spine Tumorsmentioning

confidence: 99%

“…These trends are expected to continue, and advances in MRI technology may further improve clinicians’ ability to detect small lesions. Children are frequently referred for MRIs for an array of indications, including headaches, scoliosis, lumbago, dorsalgia, and trauma workup [14, 15]. Moreover, the upper cervical spine can often be assessed on brain MRIs.…”

Section: Introductionmentioning

confidence: 99%

Approaches to Incidental Intradural Tumors of the Spine in the Pediatric Population

Hersh¹,

Lubelski²,

Theodore³

et al. 2023

Pediatr Neurosurg

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Background: Incidental intradural tumors of the spine in the pediatric population are rare lesions whose management remains unclear. Surgeons must balance the risks of iatrogenic deficits and complications after surgical resection against the risks from progressive growth of the tumor. Moreover, the natural history of an incidental finding can be difficult to predict. Here we review the literature on incidental intradural tumors of the spine and present considerations for their management. Summary: Growth of the tumor or changes in radiographic features are usually indications for resection. Asymptomatic lesions can be found in patients with genetic syndromes that predispose to tumor formation, such as neurofibromatosis type 1 and 2, schwannomatosis, and Von-Hippel-Lindau syndrome, and careful workup of a genetic cause is warranted in any patient presenting with multiple tumors and/or cutaneous features. Close follow-up is generally favored given the heavy tumor burden; however, some recommend pre-emptive resection to prevent permanent neurological deficits. Incidental intradural tumors can also occur in association with hydrocephalus, significant syringomyelia, and cord compression, and surgical treatment is usually warranted. Tumors may also be discovered as part of the workup for scoliosis, where they are not truly incidental to the scoliosis but rather are contributing to curve deformation. Key Messages: Thorough workup of patients for associated genetic syndromes or comorbidities should be undertaken in pediatric patients with incidental intradural tumors. Further research is needed into the natural history of these incidental lesions. Incidental tumors can often be managed conservatively with close follow-up, with surgical intervention warranted for expanding tumors or new-onset symptoms.

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“…Not only is there a wide variety of spinal lesions described in the literature, the treatment of these tumors, benign or otherwise, is often complex and complicated by factors such as neural compression [ 1 ]. Vertebral lesions are also frequently found incidentally when the patient presents with back pain, weakness, or myelopathy, and if management is delayed, vertebral lesions can lead to a complete loss of sensory and motor function [ 2 ]. A thorough, comprehensive understanding of the assessment and treatment of these lesions is needed.…”

Section: Introductionmentioning

confidence: 99%

Vertebral Primary Bone Lesions: Review of Management Options

et al. 2023

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The assessment and treatment of vertebral primary bone lesions continue to pose a unique yet significant challenge. Indeed, there exists little in the literature in the way of compiling and overviewing the various types of vertebral lesions, which can often have complicated intervention strategies. Given the severe consequences of mismanaged vertebral bone tumors—including the extreme loss of motor function—it is clear that such an overview of spinal lesion care is needed. Thus, in the following paper, we aim to address the assessment of various vertebral primary bone lesions, outlining the relevant nonsurgical and surgical interventional methods. We describe examples of primary benign and malignant tumors, comparing and contrasting their differences. We also highlight emerging treatments and approaches for these tumors, like cryoablation and stereotactic body radiation therapy. Ultimately, we aim to emphasize the need for further guidelines in regard to correlating lesion type with proper therapy, underscoring the innate diversity of vertebral primary bone lesions in the literature.

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Incidental vertebral lesions

Cited by 6 publications

References 59 publications

Two Cases with Incidental Finding of Large Asymptomatic Intradural Lumbar Tumors

Two Cases with Incidental Finding of Large Asymptomatic Intradural Lumbar Tumors

Approaches to Incidental Intradural Tumors of the Spine in the Pediatric Population

Vertebral Primary Bone Lesions: Review of Management Options

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