SPINAL TUMOR

A spinal tumour can be benign or malignant and develops within or near the spinal cord in the bones of the spine or may have metastasized from some other part of the body – most commonly breast or prostate.

 

Some spinal tumours originate within the bones of the spine (primary tumours) and may be benign or malignant. More often, spinal tumours result from cancer cells that have spread from tumour sites elsewhere in the body (secondary tumours). All spinal tumours can cause pain or other neurological problems by impinging on nerves or the spinal cord, or by disrupting the blood supply to structures that are near or within the spinal cord.

 

Examples of Benign tumors are schwannoma and meningioma.

Examples of malignant tumors are malignant Ependymoma and metastasis.

​

​

SYMPTOMS

Spinal tumors present with symptoms that are dependent on the site of lesion and the severity of the spinal cord compression. These symptoms are:

1. Back pain at the site of the tumour

2. Weakness & numbness or abnormal sensations in the extremities

3. Bowel or urinary incontinence.

​

 

INVESTIGATIONS

Your treating spine surgeon will conduct a thorough neurological examination and order the relevant investigations. Treatment is planned accordingly. You may be advised to have

1. Blood / Urine Tests – Blood tests (such as serum protein electrophoresis) may pick up cancers (such as multiple myeloma) which may involve the spine. In these cases the urine tests may be positive for Bence-Jones protein. 

2. X-rays

3. CT scan (computerized tomography scan)

4. MRI (magnetic resonance imaging)

5. Myelogram - An X-ray or CT scan that is done after a contrast has been injected into the Cerebro-Spinal Fluid (CSF).

6. PET CT / PET MRI - Recently there has been increasing use of PET CT or PET MRI in cases of spine metastasis, where the primary tumour site is unknown.

7. Lumbar Puncture - In some cases, a sample of your cerebral spinal fluid (CSF) will be collected for analysis, particularly cytology for malignant cells.

8. CT-guided biopsy / FNAC - Once investigation is complete, either the primary tumour or the spinal lesion can be biopsied under CT- guidance or FNAC (Fine Needle Aspiration Cytology) and material sent for analysis.

 

With these above tests, your physician can localize the location of the tumour and, in some cases, have an idea of the nature of the tumour.

​

​

TREATMENT OPTIONS

Usually an oncologist (medical or radiation) is involved in treatment planning.

1. Removal and biopsy report, your spine team may also advise radiation therapy and/or chemotherapy as part of the treatment tumor Medical and Radiation Management 

2. Surgical Management - Spinal tumors that are causing compression of structures in or near the spine must be treated first by surgery and complete excision is the goal. In many cases, surgery is the most effective course of action. If the tumour has made the spine unstable or is unstable after surgery, spine stabilization is necessary. Tumours within and around the spinal cord need microsurgery.