Spinal cord tumors are abnormal growths of tissue found inside the bony
spinal column, which is one of the primary components of the central nervous
system (CNS). Benign tumors are noncancerous, and malignant tumors are
cancerous. The CNS is housed within rigid, bony quarters (i.e., the skull
and spinal column), so any abnormal growth, whether benign or malignant,
can place pressure on sensitive tissues and impair function. Tumors that
originate in the brain or spinal cord are called primary tumors.
Most primary tumors are caused by out-of-control growth among cells that
surround and support neurons. In a small number of individuals, primary
tumors may result from specific genetic disease (e.g., neurofibromatosis,
tuberous sclerosis) or from exposure to radiation or cancer-causing chemicals.
The cause of most primary tumors remains a mystery. They are not contagious
and, at this time, not preventable.
Spinal cord tumor symptoms include pain, sensory changes, and motor problems.
Symptoms generally develop slowly and worsen over time unless they are
treated. Tumors within the spinal cord usually cause symptoms over large
areas of the body, while tumors outside the spinal cord may grow for some
time before causing nerve damage. Other symptoms include back pain, loss
of sensation, muscle weakness, incontinence and muscle spasms.
The first test to diagnose brain and spinal column tumors is a neurological
examination. Special imaging techniques (computed tomography, and magnetic
resonance imaging, positron emission tomography) are also employed. Laboratory
tests include the EEG and the spinal tap. A biopsy, a surgical procedure
in which a sample of tissue is taken from a suspected tumor, helps doctors
diagnose the type of tumor.
The tumor may be classified as benign or malignant and given
a numbered score that reflects how malignant it is. This score can help
doctors determine how to treat the tumor and predict the likely outcome,
or prognosis, for the patient.
Outlined below are some of the diagnostic tools that your
physician may use to gain insight into your condition and determine the
best treatment plan for your condition.
Medical history: Conducting a detailed medical history helps
the doctor better understand the possible causes of your back and neck
pain which can help outline the most appropriate treatment.
Physical exam: During the physical exam, your physician
will try to pinpoint the source of pain. Simple tests for flexibility
and muscle strength may also be conducted.
X-rays are usually the first step in diagnostic testing
methods. X-rays show bones and the space between bones. They are of
limited value, however, since they do not show muscles and ligaments.
MRI (magnetic resonance imaging) uses a magnetic field
and radio waves to generate highly detailed pictures of the inside of
your body. Since X-rays only show bones, MRIs are needed to visualize
soft tissues like discs in the spine. This type of imaging is very safe
and usually pain-free.
CT scan/myelogram: A CT scan is similar to an MRI in
that it provides diagnostic information about the internal structures
of the spine. A myelogram is used to diagnose a bulging disc, tumor,
or changes in the bones surrounding the spinal cord or nerves. A local
anesthetic is injected into the low back to numb the area. A lumbar
puncture (spinal tap) is then performed. A dye is injected into the
spinal canal to reveal where problems lie.
Electrodiagnostics: Electrical testing of the nerves
and spinal cord may be performed as part of a diagnostic workup. These
tests, called electromyography (EMG) or somato sensory evoked potentials
(SSEP), assist your doctor in understanding how your nerves or spinal
cord are affected by your condition.
Bone scan: Bone imaging is used to detect infection,
malignancy, fractures and arthritis in any part of the skeleton. Bone
scans are also used for finding lesions for biopsy or excision.
Discography is used to determine the internal structure
of a disc. It is performed by using a local anesthetic and injecting
a dye into the disc under X-ray guidance. An X-ray and CT scan are performed
to view the disc composition to determine if its structure is normal
or abnormal. In addition to the disc appearance, your doctor will note
any pain associated with this injection. The benefit of a discogram
is that it enables the physician to confirm the disc level that is causing
your pain. This ensures that surgery will be more successful and reduces
the risk of operating on the wrong disc.
Injections: Pain-relieving injections can relieve back
pain and give the physician important information about your problem,
as well as provide a bridge therapy.
The goal when treating spinal cord tumors is to minimize nerve damage
related to compression of the spinal cord. The main priority is to administer
treatment as quickly as possible to prevent progression. The three most
commonly used treatments are surgery, radiation, and chemotherapy. Doctors
also may prescribe steroids to reduce the swelling inside the CNS.
Spinal tumors can be benign (non-cancerous) or malignant (cancerous). Metastatic spinal tumors are those that spread (metastasize) from another cancer in another area of the body. See "Spinal Malignancy" for information on metastatic cancerous tumors.
Intradural-Extramedullary Tumors
Intradural-extramedullary tumors grow in the spinal canal between the dura (the tough covering over the nerve) and the spinal nerve. Although usually benign and slow-growing, they can cause pain and weakness. Two types of these tumors are meningiomas and nerve sheath tumors (such as schwannomas and neurofibromas).
Intramedullary Tumors
Intramedullary tumors grow inside the spinal cord or individual nerves and occur most frequently in the cervical (neck) spinal cord. Astrocytomas and ependymomas are the two most common types. Although usually benign, they are difficult to remove. Intramedullary lipomas are rare congenital tumors most commonly located in the thoracic spinal cord. These tumors are not neoplasms; these tumors are like normal adipose (fat) tissue. They increase in size and in relation to fatty tissue elsewhere in the body.
FAQs
What are some of the symptoms of spinal cord tumors?
Numbness in the legs that is worsening
Back pain
Incontinence
Muscle spasms
Cold feeling in the legs or hands
What is the prognosis?
The earlier the spinal cord tumor is detected, the better the outlook.
Without treatment, spinal tumors can lead to serious disability, paralysis
and death.
Click here for narrated videos of spine surgeries, procedures and what causes various symptoms. Click here to see medical illustrations that help you understand back and neck problems. Click here to see an exercise library that has special stretches that can relieve pain symptoms.
John J. Regan, MD is the author of the First Chapter of Minimally Invasive Spine Surgery: Clinical Examples of Anatomy, Indications, and Surgical Techniques.
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We understand that traveling with a back problem can be difficult and unsettling. That’s why we enable you to set up a telephone consultation with Spine Group Beverly HIlls in advance, to determine if a trip would be worthwhile. Because this involves significant time for our practice to receive your information and diagnostics, and for Dr. Regan to review your case in advance of your call, there is a fee for this consultation. Click here to learn more.
The vast majority of back problems improve on their own or with nonsurgical treatment. There are a few warning signs, however, that may indicate serious spinal problems. If you experience any of these symptoms, seek medical attention immediately. Click here to learn more.
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