A spinal tumor is a abnormal growth of cells in or surrounding the spinal cord. It may be cancerous or noncancerous.
Tumors that affect the bones of the spine (vertebrae) are known as vertebral tumors.
Tumors that begin within the spinal cord itself are called spinal cord tumors.
Tumors from other parts of the body can spread (metastasize) to the vertebrae, the supporting network around the spinal cord.
Spinal tumors or growths of any kind can lead to pain, neurological problems and sometimes paralysis. Whether cancerous or not, a spinal tumor can cause permanent disability and can be life threatening sometimes.
Tumors that start in spinal tissue are called primary spinal tumors. Tumors that spread to the spine from some other place (metastasize) are called secondary spinal tumors. Tumors may spread to the spine from the breast, prostate, lung, blood and other areas.
The cause of primary spinal tumors is unknown. Some primary spinal tumors occur with certain inherited gene mutations.
Spinal tumors can occur:
- Inside the spinal cord (intramedullary)- e.g. ependymoma, astrocytoma, etc.,
- In the membranes (meninges) covering the spinal cord (extramedullary – intradural)- e.g. meningioma, schwanomma, neurofibroma, etc.
- Between the meninges and bones of the spine (extradural)- e.g. metastasis, bony tumors, etc.
Or, tumors may extend from other locations. Most spinal tumors are extradural.
The tumor may press on the spinal cord or nerve roots, causing damage. With time, the damage may become permanent.
Symptoms may include:
- Abnormal sensations or loss of sensation, especially in the legs (may be in the knee or ankle, with or without shooting pain down the leg)
- Back pain that gets worse over time, is often in the middle or lower back, is usually severe and not relieved by pain medicine, gets worse when lying down or straining (such as during a cough or sneeze), and may extend to the hips or legs
- Cold sensation of the legs, cool fingers or hands, or coolness of other areas
- Fecal incontinence
- Inability to keep from leaking urine (urinary incontinence)
- Muscle contractions, twitches, or spasms (fasciculations)
- Muscle function loss
- Muscle weakness (decreased muscle strength) in the legs that causes falls, makes walking difficult, and may get worse (progressive)
Exams and Tests
A nervous system (neurological) examination may help pinpoint the location of the tumor.
These tests may confirm spinal tumor:
- Spine MRI
- Cerebrospinal fluid (CSF) examination
The goal of treatment is to reduce or prevent nerve damage caused by pressure on (compression of) the spinal cord.
Treatment should be given quickly. The more quickly symptoms develop, the sooner treatment is needed to prevent permanent injury. Any new or unexplained back pain in a patient with cancer should be thoroughly investigated.
Treatments includes one or more of following modalities:
- Corticosteroids- to reduce swelling around the tumor and nerve protection.
- Surgery- Only definitive treatment- emergency or semi-elective operation may be needed to relieve compression on the spinal cord. some tumors can be relived completely while other can only be debulked to reduce compression on spinal cord/nerves
- Radiation therapy may be used with, or instead of, surgery.
- Chemotherapy has not been proven effective against most spinal tumors, but it may be recommended in some cases, depending on the type of tumor.
- Physical therapy may be needed to improve muscle strength and the ability to function independently.