Aggressive Vertebral Hemangioma and Spinal Cord Compression: A Particular Direct Access Case of Low Back Pain to Be Managed—A Case Report

Int. J. Environ. Res. Public Health, 2022 · DOI: 10.3390/ijerph192013276 · Published: October 14, 2022

Simple Explanation

Hemangiomas are common benign tumors in the spine, but aggressive forms can cause disability. This case highlights the importance of screening for red flags and reporting a physiotherapist's reasoning for referring a patient. The case involves a 52-year-old man with intense sacral pain, which worsened while sitting. After a neurological exam, the patient was referred and diagnosed with multiple vertebral hemangiomas. The patient underwent post-surgical rehabilitation after vascular embolization. Early referral and interdisciplinary collaboration led to timely diagnosis and avoided unnecessary rehabilitation.

Study Duration

Not specified

Participants

One 52-year-old male

Evidence Level

Level 4, Case Report

Key Findings

1
Red flags screening is crucial, especially in direct access settings, for identifying underlying extra-professional pathologies in patients presenting with low back pain.
2
A combination of multiple red flags presents a greater diagnostic accuracy.
3
Collaboration between different healthcare professionals, such as physiotherapists and neurosurgeons, can lead to the best outcome for the patient.

Research Summary

This case report highlights the importance of red flags screening in a direct access environment and describes the clinical reasoning that led a physical therapist (PT) to refer a patient with low back pain caused by aggressive hemangiomas (HAs). The patient, a 52-year-old male, was examined at the authors’ private practice complaining of intense sacral pain, especially while in a sitting position. The interdisciplinary collaboration between physiotherapist and neurosurgeon was essential in guiding the patient towards recovery after endovascular embolization (EVE) and subsequent physiotherapy intervention.

Practical Implications

Importance of Red Flags

Emphasizes the necessity for physiotherapists to recognize red flags indicating conditions outside their scope of practice.

Direct Access Considerations

Highlights the need for thorough screening in direct access physiotherapy to ensure timely referrals for appropriate medical management.

Interdisciplinary Collaboration

Underscores the benefits of collaboration between physiotherapists and other healthcare professionals for optimal patient outcomes.

Study Limitations

1
The study is limited to a single case report, which may not be generalizable to all patients with aggressive vertebral hemangiomas.
2
The evaluation lacks a standardized questionnaire to assess the patient's degree of satisfaction.
3
The study does not provide long-term follow-up data to assess the durability of the treatment effects.

Your Feedback

Was this summary helpful?

Back to Surgery