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Spinal Tumors

It is a distressing experience for a patient to learn that he or she has been diagnosed with a spinal tumor.  However, there are many different types of spinal tumors and various treatment options, and the prognosis for many tumors is better today than it was even just a few years ago. 

This article provides an overview of the types of spinal tumors and the various treatment options.  It begins by addressing tumors and their treatment in a general sense, and then moves on to address specific types of tumors.

Classifying Spinal Tumors
Spinal tumors are abnormal growths of new tissue called neoplasms. They are relatively rare in the spine. In general, neoplasms are classified as benign (not cancerous) or malignant (cancerous). While benign tumors may be destructive to normal bone tissue, they do not invade other tissues. However, malignant tumors have the potential to both invade the structure of the spinal vertebrae and to spread to other organs.

Other basic terms to help classify a tumor are:

The symptoms caused by a spinal tumor depend on many factors, including the tumorís location, how quickly it grows, invasion into other spinal elements, spinal cord and nerve involvement, and its effect on spinal stability.

Back and leg pain may be the initial symptoms of spinal tumors. Some spinal tumors may cause leg or arm weakness and numbness, sciatica, partial paralysis, clumsiness, spasticity, bowel or bladder problems, or spinal deformity. Symptoms may develop gradually or appear suddenly, and symptoms usually worsen unless treated.

The diagnostic process requires taking a detailed patient medical history and performing a physical and neurological examination. Additionally, lab tests and imaging studies can help to reveal aspects about the patientís health that may not be apparent during the examinations.

Lab Tests

Imaging Studies

Spinal Tumor Biopsy
After imaging studies are completed, biopsy is the best way to ascertain the tumor type. A biopsy is the microscopic examination of the tumor tissue and cells. Biopsy is often the only way to reach a definitive diagnosis of cancer.

The procedure used to obtain the tumor specimen (sample) depends on many factors including the tumor location and the patientís health. Biopsies can be performed two ways. A needle biopsy is performed through the skin (percutaneous) using image guidance, such as fluoroscopy. Tumor specimens can also be obtained using an open surgical procedure.

Treatment Options
Spinal tumor treatment often requires the expertise of several specialists including a spine surgeon, neuroradiologist, pathologist, oncologist, and pain management specialist.

The type of treatment usually depends on the patientís symptoms and health, imaging studies, and biopsy results. Many patients require a combination of non-surgical and surgical treatments. Each case is evaluated on an individual basis and the treatment is designed to meet the patientís needs.

Non-Surgical Treatment
The type of non-surgical treatment determined appropriate is dependent on many factors including the type of tumor (benign or malignant), its stage, treatment objective (e.g. pain reduction, cure), and patientís life expectancy and overall health.

Surgical Treatment
The goal of surgery, whether the spinal tumor is benign or malignant, is to reduce pain and to restore or preserve neurological function and spinal stability. Even after surgical resection (partial removal) or excision (complete removal), some tumors require non-surgical treatment such as radiation or chemotherapy.

Surgery to treat a spinal tumor may be warranted when a specimen is needed (open biopsy), the tumor causes spinal cord or nerve compression, neurological deficit progresses, pain is unresponsive to non-surgical treatment, vertebral destruction exists, and spinal instability develops.

Surgical Considerations:

Spinal Instrumentation and Fusion:
These procedures are used together to stabilize and reconstruct the spine. Instrumentation utilizes medical grade hardware such as cages, rods, and screws to stabilize the spine during fusion. Bone graft, bone cement, or BMPs, are used with instrumentation to facilitate fusion. As the graft material joins and grows around the instrumentation, spinal fusion occurs and creates a solid construct. The patient may need to wear a special brace following surgery to stabilize the spine while fusion takes place.

The amount of time the patient is hospitalized depends on the type of procedure performed and the side effects experienced. For example, the side effects from radiation therapy or chemotherapy can be significant and may include nausea, loss of appetite, and fatigue. Fortunately, these side effects are treatable.

After surgery, the treating physician closely monitors the patientís condition and recovery. Periodic re-evaluation may require new lab tests and imaging studies. Pain management may be a component of long-term treatment. Physical therapy may be prescribed to help a patient rebuild flexibility and strength. Additionally, the treating physician may add nutritional support to the patientís recovery program.

Types of Tumors
The following section provides a brief summary of several of the most common types of spinal tumors, and highlights the most common treatments.

Primary Benign Tumors

Primary Malignant Tumors

More Spinal Information

Spinal Fusion with Instrumentation
Preparing for Spine Surgery
Recovering From Spine Surgery