Spinal Tumors Overview
Spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and spinal column. The cells in a tumor grow and multiply uncontrollably. Their growth seems to be unchecked by the natural bodily mechanisms that control growth of normal cells. Spinal tumors can be benign i.e. non-cancerous. They can also be malignant i.e. cancerous. The primary tumors originate either in the spine of spinal cord. The secondary or metastatic tumors usually spread from another location to the spine. We, at Spine Physicians Institute, have seen and successfully treated this condition in many patients.
The primary malignant tumors must be promptly diagnosed and identified for it to have proper treatment. There are numerous factors which can affect the outcome of the disease, such as;
- The nature of the primary cancer
- The number of lesions
- The presence of distant non-skeletal metastases
- The presence and/or severity of spinal-cord compression
Unfortunately, the cause of most primary spinal tumors remains unknown. Some of the cases might be attributed towards the exposure to cancer causing agents. Spinal cord lymphomas are more common among people who have compromised immune systems. There is also most likely a genetic component to tumors because it has higher chance of occurrence in certain families. In a small number of cases, primary tumors may result from presence of two genetic diseases. They are neurofibromatosis 2 and von Hippel-Lindau disease.
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The non-mechanical back pain is most common symptom of benign, as well as malignant tumors. This pain is centered towards middle or lower back. The pain is not specifically attributed to injury, stress or physical activity. However, it may increase with activity. It could also worsen at night. It may spread beyond the back to the hips, legs, feet or arms and may even worsen over time. It could become worse even if the pain is treated by conservative, nonsurgical methods that can often help alleviate back pain attributed to mechanical causes.
Other signs and symptoms can develop depending on the location and type of tumor. A malignant tumor can grow or compress on the spinal cord, nerve roots, blood vessels or bones of the spine. Impingement of a tumor on the spinal cord can be life threatening in itself. The additional symptoms can be one or a combination of the following;
- Loss of sensation or muscle weakness in the legs, arms or chest
- Decreased sensitivity to pain, heat and cold
- Loss of bowel or bladder function
- Paralysis occurring in varying degrees and in different parts of the body. It depends upon which nerves are compressed
- Scoliosis or other spinal deformity resulting from a large, but benign tumor
A physician takes the first step in diagnosing a spinal tumor by giving a thorough medical examination to the patient. This examination is done with emphasis on back pain and neurological deficits. Radiological tests are required for an accurate diagnosis. An MRI scan is the best way to look at all parts of the spinal cord and spine itself. X-ray, CT scan or even a CAT scan may be used to get accurate analysis of the affected area.
If the presence of a tumor has been confirmed through radiological testing, biopsy is the only way to confirm whether the tumor is benign or malignant. A small tissue sample is extracted through a biopsy procedure and examined under a microscope. If the tumor proves to be a malignant one, then the biopsy can also help determine the type of cancer. This subsequently determines which treatment options to take.
Non-surgical treatments for metastatic spinal tumors include observation, medication, chemotherapy and radiation therapy. The tumors that appear to be asymptomatic, mildly symptomatic can be observed and monitored with regular MRIs. Such tumors usually do not appear to be changing or progressing.
There are some specific types of metastatic tumors that are inherently radioresistant. These are usually found in gastrointestinal tract and kidney. In such cases, surgery may be the only viable treatment.
The goal of a surgery for spine tumor is to restore spinal stability, function, decompression of neural elements, pain reduction and prevention of tumor recurrence or spread. Indications of surgery vary depending upon the type of tumor. Primary spinal tumors may be removed though a complete ‘en bloc resection’ for possible cure. En bloc resection is a surgical procedure which removed the tumoral mass in its entirety, while also surrounded by this layer of healthy tissue.
Palliative treatment is usually recommended for patients suffering from metastatic tumor. The patients are taught to manage symptoms and the side effects. Its goal is to restore or preserve neurological function, stabilize the spine and alleviate the pain.
The surgical option for patients suffering from metastatic tumor is only recommended when they are expected to live 12 weeks or longer. The tumor must also be resistant to radiation or chemotherapy. Indication for surgery include intractable pain, spinal cord compression and the need for stabilization of impending pathological features.
The outcome of treatment for spinal tumor depends on a lot of factors. The age and overall health of the patient affects the outcome a lot. The type of spinal tumor; whether it is benign or malignant, primary or metastatic also has a lot of effect on outcome. The goal in case of primary tumors is to remove them completely. This can optimally lead to the potential cure of malignancy. The goal for metastatic tumors is almost always palliative. At best, the treatment may provide the patient with an improved quality of life as well as prolonged life expectancy.
For more questions, contact our offices located in Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville and Duncanville marketplaces.