Algorithm of Treatment for Extensive Vertebral Hemangiomas According to Tomita Classification of Vertebral Tumors

Vertebral hemangiomas (VHs) are considered benign tumors consisting in vascular spaces lined by endothelium. Despite this definition they may develop and become extensive and symptomatic, in these cases they are called “aggressive”. A wide range of treatment options are available for symptomatic and extensive VHs such as radiotherapy, radiosurgery, embolization, alcohol injection, vertebroplasty, kyphoplasty, laminectomy, intralesional resection and total en bloc spondilectomy.