Primary Benign Neoplasms of Spine

Abstract

Abstract Majority of primary vertebral tumours are benign and are often diagnosed incidentally on imaging. It is crucial to have an accurate diagnosis to avoid missing more threatening malignant lesions or infection. Many of these primary benign lesions can be locally aggressive and cause neural compromise or pain requiring active management. The most common benign tumours are osteomas and haemangiomas. Other benign tumours are similar to those observed in the appendicular skeleton, for example, osteoid osteoma, osteoblastoma, fibrous dysplasia, osteochondroma, chondroblastoma, haemangioma, simple bone cysts, aneurysmal bone cysts, giant cell tumours, eosinophilic granuloma and notochordal rests. Most of these tumours are asymptomatic; however, locally aggressive lesions, for example, aneurysmal bone cysts or giant cell tumours, are characterized by back pain, neurological deficits and spinal instability. Sometimes, it is difficult to distinguish from more commonly encountered pain due to degenerative disc disease or malignant lesions and metastatic spine tumours, thus necessitating imaging techniques such as radiography, computed tomography and magnetic resonance imaging, which help in diagnosis. Generally, most incidental or asymptomatic lesions are managed conservatively, while symptomatic or locally aggressive lesions warrant active interventions. Some of these tumours require surgical resection or percutaneous techniques such as radiofrequency ablation, sclerotherapy or cryotherapy with favourable outcomes. This review elaborates different types of primary benign vertebral tumours, supported by characteristic imaging features.