Spinal tumor

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at October 22, 2016
StartDiseasesSpinal tumor

A spinal tumor or vertebral tumor is a tumor that grows in the spinal cord or vertebra.

Contents

Definition & Facts

Types of spinal tumors include intradural intramedullary spinal cord tumor and intradural extramedullary tumor. Intradural tumors are located inside the dura mater. Intramedullary tumors are located inside the medulla which is the substance of the spinal cord. All intramedullary tumors are necessarily intradural.

Examples of intramedullary tumors include astrocytoma, ependymoma, and hemangiobastoma. Intramedullary tumors are typically benign, that is, slow-growing. Examples of intradural extramedullary tumors (that is, tumors that grow within the dura mater but outside of the medulla) are meningiomas, neurofibromas, and schwannomas.

Primary spinal tumors (those that originate in the spine) are usually intradural whereas spinal tumors that originated elsewhere and metastasized to the spine are typically extradural. Extradural spinal tumors are located outside of the dura mater. Examples include vertebral column tumors.

Some spinal tumors are cancerous where others are not. Whether or not a spinal tumor is cancerous, it can cause permanent disability and paralysis if not treated promptly.

Symptoms & Complaints

Symptoms of spinal tumors vary depending on the location, types, and severity. Symptoms can persist for years before diagnosis. Various symptoms also develop as a spinal tumor grows, and this may also affect blood vessels and nerves.

Back pain is one of the common complaints of spinal tumor patients, especially back pain that radiates to other parts of the body. Back pain appears in cancerous and non-cancerous spinal tumors. The pain can spread to hips, arms, legs, and feet. This may become severe even if treated depending on the patient's condition.

A corresponding loss of sensation in the legs as well as in the arms can result from a spinal tumor. Sometimes, a person with a spinal tumor may experience difficulty walking. There can also be a significant decrease in sensitivity to heat and cold and also to pain.

Patients may also experience loss of bladder function and loss of bowel function. Another symptom is muscle weakness, especially around the location of the spinal tumor.

Spinal tumors develop at varying rates with correspondingly severe symptoms. Cancerous spinal tumors develop much faster than non-cancerous spinal tumor. However, both cancerous and non-cancerous spinal tumors can compress the spinal cord, and this will result in loss of movement and sensation. Moreover, both cancerous and non-cancerous spinal tumors can cause permanent nerve damage.

Causes

Causes depend on the type of spinal tumor. Certain spinal tumors are linked to von Hippel-Lindau disease and neurofibromatosis type II. Both diseases usually cause the development of non-cancerous spinal tumors instead of cancerous tumors.

Von Hippel-Lindau disease is a genetic disorder that is usually inherited. The VHL gene is a tumor suppressor gene and when genetic mutations occur that prevent the production of this gene, tumors form, sometimes in or on the spine.

Neurofibromatosis type II results from genetic mutations of the NF2 gene. NF2 produces merlin which is a tumor suppressor gene. Mutations that inhibit the production of this substance result in the formation of tumors.

Exposure to environmental intoxicants may be a causal factor though it is inconclusive which environmental factors if any put a person at risk for spinal tumors.

A spinal tumor is common in people who have a prior history of cancer. This is because any type of cancer may metastasize and travel to the spine. There are many types of cancer that can cause the development of spinal tumors. These types of cancer include prostate cancer, lung cancer, breast cancer, and multiple myelomas.

Diagnosis & Tests

Spinal tumors often go undiagnosed for years because their symptoms and complaints are often similar to those of many other, less serious conditions. In addition to intaking a patient's medical history and family history and performing a physical examination, the physician will gain information about the patient's symptoms.

If a doctor suspects a patient's symptoms to be a spinal tumor, several diagnostic tests will be recommended to confirm it. Spinal magnetic resonance imaging (MRI) is one of the tests that can be used. This test can accurately reveal the spinal cord and nerves in clear pictures. For this reason, doctors can see if there is a bone tumor.

An MRI is more accurate than a computed tomography (CT) scan but a CT scan can also be conclusive. The combination of both tests may also be necessary depending on severity. A spinal biopsy may also be performed to confirm the presence of spinal tumor. A sample tissue from the area will be needed in order to examine the tissue separately. Biopsy for spinal tumor is a very delicate process.

Treatment & Therapy

Spinal tumor treatment involves surgically removing the tumor itself. However, removing the spinal tumor can entail damaging the spinal cord and the nerves around it. Before the treatment, doctors will take into consideration several factors such as age, gender, history of diseases, and overall health of the patient. Afterward, doctors will go on to make a treatment plan.

If surgery is determined to be too risky, radiation therapy may be performed. Chemotherapy may also be used to treat it.

Prevention & Prophylaxis

Since the cause of spinal tumors remains unknown in many cases, there are also no clear guidelines on how to prevent them. To the extent that cancers originating elsewhere (like the lung and breast) spread to the spine (bone metastasis), prompt detection and treatment of those primary tumors will reduce the risk of spread.

Adopting healthy lifestyle habits such as a healthy diet and regular exercise is a prudent preventative measure. Regular doctor's visits are important in promoting one's health and detecting diseases early.