Spinal Tumor

Overview

A spinal tumor (also known as a spinal cord tumor) is an abnormal growth of cells in or around the spinal cord. Like [brain tumors], spinal tumors are central nervous system tumors, and they can be malignant (cancerous) or benign (noncancerous). Spinal tumors that develop in the spinal cord are known as primary spinal tumors, and tumors that originate elsewhere in the body and spread to the spine are called metastatic spinal tumors.

A spinal tumor can squeeze and damage the spinal nerves, causing a variety of symptoms. Treatment seeks to manage or prevent nerve damage, and it may include both surgical and nonsurgical options. Learning more about these treatment options, as well as spinal tumor symptoms, diagnosis and types, empowers patients to partner with their medical team to select the most appropriate course of treatment.

Types

A spine tumor can occur in any of the spine’s four regions and may be categorized by location, including:

  • •Extradural. An extradural tumor occurs outside the dura, which is a membrane that surrounds the spinal cord. Many extradural tumors are metastatic, which means they have spread.
  • Intradural-extramedullary. This type of spinal tumor is located inside the dura but outside the spinal cord. Intradural-extramedullary tumors include nerve sheath tumors, such as schwannomas and neurofibromas, as well as meningiomas and ependymomas.
  • Intramedullary. Intramedullary tumors occur in the spinal cord. These tumors are far less common than extradural and intradural-extramedullary tumors. Most intramedullary tumors are astrocytomas or ependymomas.

Symptoms

  • Back pain, typically in the middle or low back, that may get worse during activity or when lying down
  • Muscle spasms
  • Loss of bowel or bladder control
  • Loss of sensation in the legs
  • Pain that spreads from the back to the hips, legs or arms
  • Paralysis
  • Spinal deformity
  • Weakness in the legs

Prevention

  • Currently, it is not possible to prevent most spinal tumors.
  • Reducing or avoiding radiation exposure may help reduce your risk of developing a spinal tumor.

Risk Factors

  • A weakened immune system
  • Certain genetic conditions, including neurofibromatosis types 1 and 2, tuberous sclerosis, von Hippel-Lindau syndrome, Li-Fraumeni syndrome and Turcot syndrome
  • Family history of spinal tumors
  • Radiation exposure, such as medical radiation therapy

Diagnosis

  • Medical history and physical examination. You and your physician will discuss your health history and symptoms. He or she will check your physical function and look for abnormalities that could indicate a spinal tumor.
  • Neurological exam. Your physician may conduct a detailed assessment of your alertness, balance, coordination, reflexes and other neurological functions.
  • Imaging tests. A variety of imaging tests may help establish a diagnosis of a spinal tumor by showing the spinal cord and surrounding bones and tissues. These tests include X-ray, CT, MRI and PET scan. A bone scan can help find bone tumors.  
  • Biopsy. Obtaining a sample of tumor tissue can help determine whether a growth is benign or malignant. •
  • Lumbar puncture. Also known as a spinal tap, this procedure uses a needle to obtain a sample of cerebrospinal fluid to check for cancer cells.

Treatment

Every spinal tumor is different. Your medical team will decide on the best course of treatment for you based on the tumor’s location, stage and many other factors. Treatment options include:

  • Surgery. For some tumors, complete surgical removal is possible. In other cases, the goal of surgery is to remove as much of the tumor as possible to relieve nerve compression. 
  • Radiation therapy. You may receive radiation therapy as a primary treatment or to destroy any portions of tumor that were not removed during surgery. Most types of radiation therapy are external, and many can precisely irradiate tumors while avoiding or minimizing damage to healthy structures.
  • Chemotherapy. Oral or intravenous drugs to kill cancer cells are not as effective at treating spinal tumors as brain tumors. If you receive chemotherapy, it will likely be in conjunction with other treatments.
  • Targeted therapy. These drugs, which disrupt cancer cells based on specific mutations, may serve as a helpful alternative to standard chemotherapy for a small number of tumor types.

Follow-up Care

  • After treatment ends, you may need to undergo regular tests to watch for a recurrence of the tumor. Work with your physician to create a survivorship plan that includes a schedule of follow-up tests and appointments. Your plan may also include education about side effects to watch for and tips for managing them if they occur, as well as steps you can take to promote overall health
  • Keep all follow-up appointments. If the tumor recurs, it is important to detect and treat it as quickly as possible.
  • If you experienced any side effects of the tumor or treatment, your physician may refer you to specialists. They can address side effects and improve your quality of life.
  • Notify your physician if you experience any new symptoms.