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BACKGROUND: In the arsenal of a physiotherapist, there are many methods of non-drug rehabilitation. As contraindications to their use, spinal neoplasms, benign formations with a tendency to growth are indicated, among other things. At the same time, there is no data in the literature on contraindications to physiotherapy in the presence of non-aggressive vertebral hemangioma. As well as there are no scientific studies with a proven absence of a negative effect on the course of this tumor. AIMS: scientific substantiation of the use of physical methods of treatment of patients with degenerative-dystrophic diseases of the spine in the presence of non-aggressive vertebral hemangioma. MATERIAL AND METHODS: The study involved 154 patients with degenerative-dystrophic diseases of the spine and non-aggressive vertebral hemangioma. 94 patients were analyzed retrospectively, 60 took part in a prospective study. The following methods of physical therapy were used in the treatment of all patients: magnetotherapy, electrotherapy, physical therapy and massage. All patients underwent computer or magnetic resonance imaging of the spine before the start of treatment and 1 year after the end of treatment with an assessment of the presence or absence of hemangioma growth in dynamics. RESULTS: In 94 patients with degenerative-dystrophic diseases of the spine in combination with non-aggressive vertebral hemangioma, who received various methods of physiotherapy, a different proportion of cases of increase in the size of vertebral hemangioma was noted upon repeated examination after 1 year. At the same time, in no case did the vertebral hemangioma acquire signs of aggressiveness. The minimum frequency of increasing the size of vertebral hemangioma was noted in patients after magnetic therapy, therapeutic gymnastics and massage. As a result of the use of magnetotherapy, electrotherapy, therapeutic gymnastics and massage in 60 patients, the growth of vertebral hemangioma was detected only in 1 case. CONCLUSION: In patients with degenerative-dystrophic diseases of the spine, local low-frequency electrotherapy, magnetic therapy, physical therapy and therapeutic back massage did not significantly affect the frequency of cases of increase in the size of vertebral hemangioma. The possibility of using other methods of physiotherapy in the treatment of patients with degenerative-dystrophic processes of the spine in the presence of non-aggressive vertebral hemangioma requires further research.

An analytical review of publications devoted to various aspects of vertebral hemangioma was conducted from following electronic databases: Scopus, Web of Science, MedLine, The Cochrane Central Register of Controlled Trials, ScienceDirect, PubMed, and elibrary, CyberLeninka. The review contains actual data on the frequency of its occurrence, the possible causes of appearance and variants of development. The issues of diagnosis of vertebral hemangioma are considered in the historical context: clinical manifestations, objective modern sur- vey methods. Special attention is paid to the morphological and pathogenetic criteria for changes in the verte- bra. It is connected with the fact, that the diagnosis vertebra hemangioma prior to the morphological study is more a collective concept than a definitive diagnosis. It is noted that the modern concept of therapeutic tac- tics is based on the nature of course of vertebral hemangioma: aggressive and non-aggressive forms. The article presents the criteria for its aggressiveness according to domestic and foreign authors. The main methods of treating neoplasm are presented: radiation therapy, alcoholization, puncture embolization of tumor vessels, puncture vertebroplasty, stenthoplasty, open interventions. In the conclusion of the review, it is emphasized that if medical tactics in case of aggressive vertebral hemangiomas are actively developed by scientific researchers, today studies on sufficient clinical material with the long-term analysis of differentiated application of physio- therapeutic treatment of the patients with vertebral pain syndromes in combination with non-aggressive vertebral hemangioma do not exist.