Spinal Tumors

Tumors of the Spine

1. Tumors of the Vertebral Column

• Primary tumors: Primary tumors form in the vertebral column and grow from the bone or disc elements of the spine. They are more common in young adults. The most common malignant bone tumour is osteogenic sarcoma (osteosarcoma). Most primary spinal tumors are uncommon and grow slowly.
• Metastatic tumors: Spinal tumors usually metastasize (spread) from cancer in another part of the body. These tumors typically cause pain that does not improve with rest, may be worse at night, and is frequently accompanied by other symptoms of serious illness (such as weight loss, fever, chills, shakes, nausea, or vomiting).
  Spinal tumors most commonly spread from cancers that begin in the breast or lung in women.
  Spinal tumors most commonly, spread from cancers that begin in the prostate or lung in men.

2. Intradural and Extramedullary Tumors

Tumors that grow inside the spinal canal (under the membrane that covers the spinal cord) but outside of the nerves are known as intradural-extramedullary (inside the dura). These tumors are typically benign and slow-growing. They can, however, cause pain and weakening symptoms.

The majority of these spinal tumors are:

!. Meningiomas Meningiomas are benign tumors that develop in the membranes surrounding the spinal cord. They can also be malignant. These tumors are more common in women in their forties and fifties.

2. Nerve sheath Tumors (schwannomas and neurofibromas) Nerve sheath Tumors (schwannomas and neurofibromas )develop from nerve roots exiting the spinal cord. Again, this type of tumor is usually benign and slow-growing, and any neurological problems may not appear for years.

3. Intramedullary Tumors

Intramedullary tumors develop from within the spinal cord or individual nerves, and they frequently arise from the cells that provide physical support and insulation to the nervous system (glial cells). These tumors are most commonly found in the cervical spine (neck). They are usually harmless, but surgery to remove the tumour can be difficult.

Astrocytomas and ependymomas are the two most common types of intramedullary tumours.

If a tumour is discovered in the spine (and no other known cancer), a thorough examination of all common organs where cancer develops is usually recommended. Evaluation may include the following:

• Full medical history
• Comprehensive physical examination
• Comprehensive neurological evaluation
• To screen for tumors, radiographic studies of the spine, chest, and GI system are performed.
• MRI and CT scans are used to examine the spine.
• The treatments for each common type of spinal tumour are discussed in greater detail below.

Treatment of Tumors of the Vertebral Column

Because the majority of these tumors are the result of advanced cancer from another organ, the goal of spinal treatment is usually to cure the cancer.

• Control the severe pain that is frequently associated with these Tumors(e.g. by removing pressure on the nerve roots)
• Maintain neurological function (e.g. by relieving spinal cord compression)
• Repair spine structural instability (e.g. by repairing the shaky spine with a spinal fusion)