Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 97. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | 962 Section Tumors and Inflammation Figure 5. MRI findings of a benign hemangioma Typical spotted bright signal intensity changes within a benign hemangioma. the vertebral body of L1 on a T1W and b T2W image suggesting Figure 6. MRI findings in primary spinal tumors a Expansive lesion with a pseudocapsule with compression of the spinal cord and the retropharyngeal space. Note the skip lesion at the level of C7 arrow same patient as in Fig. 4a b . Extension of a hypointense mass into the foramen L5 and the adjacent facet joint L4 5 on a T2W axial b and T1W sagittal image c same patient as in Fig. 4c d . Primary Tumors of the Spine Chapter 33 963 Table 2. Primary malignant spinal tumors Lesion Age Location Histology Imaging Osteosarcoma Fourth decade Vertebral body Lumbosacral region Osteoid within sarcomatous tissue Osteosclerotic and osteolytic areas with soft tissue component common extension to posterior elements Chondrosarcoma Fifth decade Predilection for vertebral body Thoracic region Hyaline cartilage with increased cellu-larity within myxoid matrix Bone destruction with characteristic punctuate calcifications Malignant fibrous histiocytoma Second to eighth decades Vertebral body Mixture of histiocytes fibroblasts and primitive mesenchymal cells Lytic lesion with low signal on T1W and high signal on T2W images Giant cell tumor Third decade Vertebral body Sacrum Osteoclastic giant cells intermixed with spindle cells Osteolytic geographic area with soft tissue component Plasmo-cytoma 40 years old Vertebral body Thoracic and lumbar spine Sheets of plasma cells on a delicate reticular stroma Radiolucent areas or reduction in bone density Hypointense on T1W and hyperintense on T2W images Ewing s sarcoma Second to third decades Vertebral body lumbosacral spine Sheets of small round blue cells Lytic lesion associated soft tissue mass Chordoma Middle-aged patients Exclusively affects vertebral body most often sacrum rarely mobile spine Lobulated mass with mucinous .
