Spinal Tumors

A spinal tumor is an abnormal growth arising from any of the tissues that make up the spine. There are many different types of spinal tumors, and not all of them are malignant (spinal cancer).

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Primary and Metastatic Spinal Tumors

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Primary spinal tumors are those that originate from the spine. They are relatively rare, typically benign (not cancer), and represent a small percentage of spinal tumors. Malignant tumors can also originate from the spine, but more often they spread from elsewhere in the body to the spine.

Metastatic spinal tumors are those that have spread to the spine from other parts of the body. If a tumor can spread, it usually means it's malignant. Between 30 and 70 percent of cancer patients develop metastatic spine cancer during the course of their disease. Lung, prostate, and breast cancers are the three most common types of cancer that tend to spread to the spine.

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Where do spinal tumors occur?

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The spine is not a single location. It's made of different types of tissue that stretches the entire length of your back to your neck and pelvis. A tumor can occur in almost any tissue type.

Starting from the outer layers of the spine, some of the tissues that can develop tumors and cancers in the spine include:

• Bones that make up the spinal cord, including the bone marrow in them

• The cartilage that protects the joints in the vertebrae

• Spinal discs that fill the space between the vertebrae

• blood vessels that supply nutrients to the spine

• Peripheral nerves originating from the vertebrae

• Dura mater, pia mater, and arachnoid mater - three layers of membranes that cover the spinal cord

• Spinal cord

According to the location of the tumor in the spinal cord, spinal cord tumors are divided into three groups:

• Extradural tumors (also known as epidural tumors) form inside the spine and may involve the vertebrae, but typically do not affect the spinal cord. They are usually found in the epidural space, which is the area surrounding the outer dura membrane that protects the spinal cord.

• Intradural tumors occur within the dura and may or may not involve the spinal cord.

• Intramedullary tumors are intradural tumors that grow within the spinal cord.

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Spinal Tumor Types According to Aggression

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There are several types of masses that can be found in the spine:

• Some are malignant tumors (spinal cancer), meaning they can spread to other parts of the body.

• Some are benign tumors, meaning they are not aggressive and do not spread, but that does not mean they are harmless.

• Some may look like tumors but are actually cysts, plaques or similar masses.

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Spinal Cancer: Malignant Spinal Tumors

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Most spinal cord cancers occur within the spinal cord and do not usually affect the spinal cord. Some of the cancers that can involve the spine include:

• Osteosarcoma: A type of bone cancer that can originate in the spine but is more common in the thigh and shin bones.

• Chondrosarcoma: A tumor arising from cartilage cells around the bone. Although rare in the spine, it can sometimes develop as a primary cancer in the bones that make up the spine.

• Multiple myeloma: a cancer that affects plasma cells in the blood. Affected cells collect in the bone marrow and outer layer of bone - usually the spine. 

• Lymphoma: A group of cancers that affect immune system cells called lymphocytes. It can develop as a primary tumor in the spine, but more often occurs elsewhere and spreads to the spine.

• Chordoma: A malignant bone tumor that can develop anywhere along its length inside the spine, but most commonly in the sacrum (a bone at the base of the spine).

• Ewing sarcoma: A cancer that can affect both bone and surrounding soft tissue. It is rare in adults and represents about 1 percent of childhood cancers.

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Benign Spinal Tumors

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Although in the majority of cases these spinal tumors are benign, a small percentage may be malignant. Benign spinal cord tumors can cause problems when they grow large enough to put pressure on spinal cord tissues or other structures.

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Benign Epidural Tumors

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• Hemangioma: A growth consisting of the tissues of blood vessels within the spinal cord. These tumors are more common on the skin surface, especially in infants, but can also affect internal organs.

• Osteoid osteoma: A small tumor in the bone that is more common in children and young adults.

• Osteoblastoma: similar to osteoid osteoma but typically larger and more aggressive.

• Osteochondroma: An overgrowth of cartilage and bone that usually occurs at the end of the bone near the growth plate.

• Giant cell tumor: A tumor named for the way it appears under the microscope. It typically contains "giant" cells with multiple nuclei formed by the fusing of several cells together. Giant cell tumor of the spine typically affects the bones of the vertebrae.

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Benign Intradural Tumors

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• Meningioma: A tumor that is more common in the brain, but can also affect the dura mater, one of the meninges 

•  Such as schwannoma and neurofibroma in peripheral nerve roots coming out of the spine nerve sheath tumors may occur.

• Glioma: A tumor that grows from glial cells that support the function of the brain and spinal cord. In the spine, the more common types of glioma include:

  • Ependymoma and subependymoma: tumors that develop in the lining of the passageways in the brain and spinal cord. Sometimes they can block the flow of cerebrospinal fluid, which increases the pressure in the brain.

  • Astrocytoma: The most common spinal cord tumor in children, it can be malignant or benign.

• Hemangioblastoma: A tumor arising from blood vessels connected to the central nervous system, including the brain and spinal cord.

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Spinal Tumor and Spine Cancer Symptoms

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Symptoms of spinal cancer and spinal cord tumors can vary depending on the type and location of the tumor. It may include, but is not limited to:

• Back pain and neck pain are the most common symptoms of spinal tumors. The pain may be related to the tumor pressing on the nerves or spinal cord. Or it may be caused by changes in the alignment of the spine affected by the tumor.

• Neurological problems due to spinal tumors. These may include:

  • Radiculopathy (compression of nerve roots)

  • Myelopathy (spinal compression)

  • Bowel and bladder problems due to compression of the nerves that provide sensation and function to these organs

  • Numbness, tingling and muscle weakness

  • difficulty walking

  • paralysis

• If the tumor grows large enough to change the spinal alignment scoliosis , kyphosisIt can also cause   and similar deformities.

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Diagnosis of Spinal Tumor and Spine Cancer

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When a tumor is found anywhere in the spine, the first step is usually to determine whether it is a primary or metastatic tumor. Your doctor will likely order various tests to check your spine as well as other major organs and systems where cancer may develop. These tests and other diagnostic methods may include:

• Your complete medical history

• physical examination

• Neurological examination including pain and function assessment

• x-ray

• MRI and CT scan

• myelography

• bone scan

• Positron emission tomography (PET scan)

To confirm the exact tumor type, especially if it is a primary tumor biopsyYou may need  . A biopsy may require surgery, but in some cases a needle may be used to reach the tumor and remove a sample.

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Spinal Tumors and Spinal Cancer Treatment

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Treatment of spinal cancer and spinal tumors will differ based on tumor type, aggression, and many other factors. Your treatment options may include:

• Chemotherapy

• Like targeted proton therapy new developments in therapeutic radiologyRadiation therapy, including  

• Complete or partial surgical removal of the tumor

• Steroids to help with swelling and back pain

Some benign spinal cord tumors and cysts may not need treatment if they do not cause any symptoms.