Spinal Tumors – Dr Aditya gupta

What is a Spinal Tumor?

A spinal tumor is an abnormal growth of cells within or near the spinal cord or vertebrae. It can be benign (non-cancerous) or malignant (cancerous).

Spinal tumors can develop in any part of the spine, including the cervical (neck), thoracic (upper back), lumbar (lower back), sacrum, or coccyx (tailbone). They may originate from the spine (primary tumors) or spread from other cancers (secondary or metastatic tumors).

Types of Spinal Tumors

Spinal tumors are classified based on their location within the spine.

Intramedullary Tumors (Inside the Spinal Cord)
These tumors originate within the spinal cord itself.
Common examples: Astrocytomas, Ependymomas.
Extramedullary Tumors (Outside the Spinal Cord but Inside the Dura Mater)
These grow in the spinal cord’s protective layers but do not directly affect the cord.
Common examples: Meningiomas, Schwannomas, Neurofibromas.
Extradural Tumors (Outside the Dura Mater, Affecting the Vertebrae)
These tumors affect the bones of the spine (vertebrae) and may cause spinal instability.
Common examples: Metastatic tumors, Osteosarcomas, Chordomas.

Causes and Risk Factors of Spinal Tumors

The exact cause of spinal tumors is not always known, but certain factors increase the risk:

Genetic Mutations
Spinal tumors may occur due to DNA mutations that cause abnormal cell growth.
Inherited Syndromes
Conditions like Neurofibromatosis Type 1 and 2, Von Hippel-Lindau disease, and Li-Fraumeni syndrome can increase the risk.
Metastatic Cancer (Spreading from Other Cancers)
Lung, breast, prostate, kidney, and thyroid cancers commonly spread to the spine.
Radiation Exposure
Past radiation therapy for other cancers can increase spinal tumor risk.
Immune System Disorders
Weakened immune function may contribute to tumor growth.

Symptoms of Spinal Tumors

Spinal tumors can compress the spinal cord, nerves, and blood vessels, leading to various symptoms.

Pain (Most Common Symptom)
Persistent back or neck pain not relieved by rest.
Pain may radiate to the arms, legs, or chest.
Often worsens at night or with activity.
Neurological Symptoms
Numbness, tingling, or weakness in the arms or legs.
Loss of sensation in affected areas.
Difficulty with fine motor skills (writing, buttoning a shirt).
Loss of Bladder or Bowel Control
Compression of spinal nerves can lead to incontinence or difficulty urinating.
Paralysis or Muscle Weakness
If left untreated, tumors may cause progressive paralysis.
Spinal Deformities
Tumors in the vertebrae can cause spinal fractures or instability.

Diagnosis of Spinal Tumors

Early diagnosis is critical to prevent permanent spinal cord damage.

Physical and Neurological Examination
Doctors evaluate muscle strength, reflexes, sensation, and coordination.
Magnetic Resonance Imaging (MRI) – Gold Standard
MRI provides detailed images of the spinal cord, nerves, and tumors.
Computed Tomography (CT) Scan
CT scans help assess bone involvement and spinal stability.
Biopsy (Tissue Sample Analysis)
A biopsy confirms if the tumor is benign or malignant.
PET Scan (For Metastatic Tumors)
Determines if the tumor has spread from other parts of the body.

Treatment Options for Spinal Tumors

Treatment depends on tumor type, location, and severity.

Observation (For Small, Benign Tumors)
If the tumor is non-cancerous, slow-growing, and not causing symptoms, regular monitoring with MRI is recommended.
Medications for Symptom Management
Pain relievers (NSAIDs, opioids) to reduce discomfort.
Corticosteroids (Dexamethasone, Prednisone) to reduce swelling and inflammation.
Radiation Therapy
Used for cancerous tumors or inoperable tumors.
Can be used after surgery to kill remaining cancer cells.
Stereotactic Radiosurgery (CyberKnife, Gamma Knife) provides precise radiation targeting with minimal damage to healthy tissue.
Chemotherapy
Used mainly for malignant spinal tumors that cannot be surgically removed.
Drugs like Temozolomide or Methotrexate may be used.
Surgical Treatment for Spinal Tumors
Surgery is recommended if the tumor is:
✔ Causing severe pain or neurological deficits.
✔ Compressing the spinal cord.
✔ Growing rapidly.
Microsurgical Tumor Removal (Preferred for Intramedullary Tumors)
Minimally invasive approach using microscopes and precision tools.
Reduces spinal cord damage.
Laminectomy (Spinal Decompression Surgery)
The lamina (bony covering of the spinal cord) is removed to access and remove the tumor.
Spinal Fusion (For Spinal Stability)
Metal rods, screws, or bone grafts stabilize the spine after tumor removal.
Minimally Invasive Tumor Ablation
Radiofrequency ablation or laser therapy destroys small tumors with heat.
Recovery and Rehabilitation After Spinal Tumor Treatment
Recovery depends on tumor type, treatment method, and overall health.
Physical Therapy
Helps restore muscle strength, coordination, and mobility.
Pain Management
Medications and nerve stimulation therapy may be used for pain relief.
Occupational Therapy
Helps patients adapt daily activities if neurological symptoms persist.
Regular MRI Monitoring
Ensures the tumor does not return or grow further.

Prognosis and Long-Term Outlook
✔ Benign spinal tumors often have a good prognosis if treated early.
✔ Malignant tumors require aggressive treatment but can be managed with modern therapies.
✔ Delayed diagnosis may lead to permanent nerve damage or paralysis.