This research is a case series analysis to evaluate aggressive vertebral hemangiomas. It focuses on clinical presentation, diagnostic imaging accuracy (X-ray, MRI, MSCT, angiography), and treatment efficacy. The primary goal is to establish optimal management protocols.

Hybrid methodology integrating retrospective case reviews (from Assiut University Hospital's Orthopedic Surgery Department) with synthesis of existing literature.

Objectives:

Characterize clinical presentations and imaging findings. Compare diagnostic accuracy across modalities. Analyze treatment outcomes, including procedural success rates and complications.

Tools:

Imaging: X-ray for initial screening, MRI/MSCT for soft tissue and spinal cord involvement, angiography for vascular mapping.

Inclusion Criteria:

• Patients diagnosed with aggressive spinal hemangiomas based on clinical symptoms and imaging findings.
• Cases confirmed through diagnostic modalities such as X-ray, MRI, MSCT, or angiography.
• Patients presenting with symptoms such as pain, neurological deficits, or spinal instability attributable to the hemangioma.

Exclusion Criteria:

• Patients with incidentally discovered spinal hemangiomas (asymptomatic cases found during evaluations for unrelated conditions).
• Cases lacking sufficient diagnostic evidence to confirm aggressive spinal hemangioma.

Patients with symptomatic, radiologically confirmed aggressive spinal hemangiomas treated at Assiut University Hospital. Excludes incidentally discovered cases.