Tumors that begin to develop in and along the spinal column, including vertebrae, spinal cord, and nearby tissues, are called spinal tumors. In most cases, these tumors are malignant (cancerous) and may spread throughout the body.
In other words, a spinal tumor is an abnormal growth (mass) of cells that occurs in the spinal cord or column tissues. Moreover, a long and flexible column of bones that provides protection for the spinal cord is called the spine. In normal circumstances, it starts at the skull’s base and ends in the tailbone (a part of the pelvic area). Generally, the spinal column is a complex structure that has multiple types of cells and tissues.
Furthermore, a cylindrical structure that goes through the center of the spine from the brainstem to the lower back is called the spinal cord. It has multiple nerves and cells that carry signals from the brain to the rest of the body and vice versa. Check below some locations where tumors can appear:
- Intramedullary (inside the spinal cord)
- In the meninges (tissues) that cover the spinal cord (intradural-extramedullary)
- Extradural (between the bones and meninges of the spine)
- Bony vertebrae of the spine
In addition, the tumors can be benign (noncancerous), which grow slowly and often do not cause symptoms, or malignant (cancerous), which often grow and multiply fast. When a tumor first develops in the spine structures, it is called a primary spinal tumor. If you develop spinal tumors when cancer breaks from another part of the body and spreads to the spine, it is known as metastatic cancer. However, metastatic spinal tumors occur more frequently than primary tumors.
Types of Spinal Tumors
Physicians have categorized spinal tumors into several categories according to the following factors. For example:
- The exact location of the tumor along the spine (such as cervical, thoracic, lumbar, or sacrum)
- The location of the tumor within the spinal column (these include intradural-extramedullary, intramedullary, or extradural)
- Whether the tumor begins to grow in the spine or spreads from another part of the body
- The type of the tumor (benign or malignant)
Check below some types of spinal tumors:
- Astrocytoma – This type often begins to grow inside the spinal cord.
- Chordoma – This is a rare malignant tumor that often develops in the base of the spine (sacrum) and tailbone (coccyx).
- Ependymoma – In such cases, the tumors appear in the lining of the spinal fluid passageways in the spinal cord or brain.
- Glioblastoma – An aggressive type of spinal tumor that develops in the blood vessels that are connected to the central nervous system (including the spinal cord and brain)
- Meningioma – These tumors appear quite rarely and affect the covering of the spinal cord and brain (meninges). While most meningiomas are noncancerous, they may grow large enough to be life-threatening.
- Neurofibroma – Usually, this tumor grows on nerves in the body (including the nerves in the spinal column). In most cases, these tumors are benign and are associated with genetic disorders.
- Osteosarcoma – A type of bone cancer that begins in the spine, but often affects the thigh and shin bones.
- Schwannoma – This type occurs in the cells that surround the nerve fibers of the spinal cord. Commonly, schwannomas are benign are rarely become malignant.
- Spinal hemangioma – This tumor develops in the tissues of blood vessels inside the spinal column. Most spinal hemangiomas are primary spinal tumors that are not cancerous.
What Cancers Spread to the Spine?
Check below for the most common cancers that often metastasize to the spinal column:
- Lung cancer – This is the most common type of cancer that spreads to the spine in men.
- Breast cancer – In such cases, it spreads to the spine in women.
- Prostate cancer
- Leukemia (blood cancer)
- Lymphoma (lymphatic system cancer)
- Multiple myeloma (this is a type of white blood cell cancer)
- Melanoma (skin cancer)
- Sarcoma (connective tissue cancer)
- Kidney cancer
- Thyroid cancer
- Gastrointestinal tract cancers
How Common Are Spinal Tumors?
About 97% of all diagnosed spinal tumors are metastatic. Moreover, roughly 10,000 people develop metastatic spinal cord tumors in the United States each year. According to some studies, about 30% to 70% of people with cancer will develop metastasis to the spine.
The primary type of spinal tumors occurs very rarely and accounts for about 0.5% of all newly diagnosed tumors.
Symptoms
While some people do not experience any symptoms, others develop them based on the type and location of the tumor. In the early stages, benign tumors often do not cause symptoms because they are too small to put pressure on surrounding tissues.
However, the most common symptom for both benign and malignant tumors is back pain. Most people with spinal tumors feel pain in the middle and lower back because these are locations where tumors mostly develop. Some people may experience radicular pain. It means the pain spreads from the spine to the hips, legs, feet, or arms.
Other Symptoms
Those who develop may also experience other symptoms. Check below some examples:
- Numbness, tingling, or loss of sensation in the arms, chest, or legs
- Muscle weakness in the arms, chest, or legs
- Back or neck stiffness
- Loss of bowel or bladder control (also known as urinary or bowel incontinence)
- Muscle spasms or twitches
- Problems with walking, which increases the risk of falls
- Scoliosis
- Paralysis
If any of the previous symptoms occur, do not hesitate to visit a doctor.
Causes
The causes are different because they depend on the type you develop (primary or secondary).
Primary Spinal Tumors
Healthcare providers do not fully understand the cause of most primary spinal tumors. Some of them are caused by prolonged exposure to cancer-causing toxins and chemicals. For instance, lymphomas occur more commonly in people with a weakened immune system. Sometimes, spinal tumors run in families.
Secondary Spinal Tumors
This type of spinal tumor occurs when a tumor from another part of the body becomes large enough to break and spread to the spinal column structures. Moreover, the spine has multiple blood suppliers and is located near the lymphatic and venous drainage systems, which makes it vulnerable to metastasis.
How to Prevent Spinal Tumors?
Usually, it is not possible to prevent spinal tumors, but you can consider the following tips to reduce the risk. Check below some examples:
Primary Spinal Tumors
In rare cases, primary spinal tumors may occur due to some genetic disorders. These include:
- Neurofibromatosis type 2 (NF2) – People with this disorder are at increased risk of developing tumors in the arachnoid layer of the spinal cord or glial cells.
- Von Hippel-Lindau disease (VHL) – This genetic disorder is often associated with benign blood vessel tumors (hemangioblastomas) in the brain, retina, and spinal cord. However, it increases the risk of developing tumors in the kidneys or adrenal glands.
If you have a parent or sibling with any of the previous genetic disorders, your risk of developing spinal tumors significantly increases. However, can perform genetic tests to make sure you do not develop these tumors. Early diagnosis and proper treatment help to avoid severe symptoms and life-threatening complications.
Secondary Spinal Tumors
It is not always possible to prevent metastatic spinal tumors because there are a lot of people who are diagnosed with metastatic cancer as their initial diagnosis. The only way to prevent secondary spinal tumors is adjuvant or neoadjuvant therapy that shrinks the localized tumor. Moreover, experts continue researching new types of treatment.
Diagnosis
Commonly, primary spinal tumors are found accidentally during an imaging test done for other reasons because they are often asymptomatic (do not cause symptoms). If you experience symptoms (especially back pain), it is important to see a doctor to rule out cancer. Usually, most people think back pain is related to a previous or current injury.
Commonly, doctors begin the diagnosis of spinal tumors with a neurological examination to check for abnormalities linked to the disease. These include tenderness in the spine, loss of pain or temperature sensation, abnormal reflexes, or muscle weakness. However, to confirm a spinal tumor, physicians often perform the following tests. For example:
- Imaging tests – Usually, doctors perform spine X-rays, MRI (magnetic resonance imaging), or CT (computerized tomography). These tests help identify the exact location and size of the tumors.
- Biopsy – During this procedure, doctors will remove a small sample of the tumor for testing under a microscope. Thus, a pathologist studies the sample to determine if it is growing and spreading to other parts of the body.
- Bone scan – This test is used when your doctor suspects bone cancer. It uses a small amount of radioactive material that is inserted into a vein to get clearer images on X-rays.
- Blood tests – These tests are often done to check the levels of Calcium and Alkaline phosphatase in the blood. These substances are often present when bone tissue breaks down. Sometimes, this is a symptom of cancer.
Treatment
The treatments are very individualized and depend on several factors. For example, the location, type, and size of the tumor, overall health, age, and preferences. In general, the metastatic spinal tumor treatment goal is to ease the symptoms, maintain or improve the function of the spine and spinal nerves, and improve your quality of life. Usually, treatment of spinal tumors involves multiple healthcare professionals. These include:
- Neurologists
- Spinal surgeons
- Radiation oncologists
- Orthopedists
- Urologists
- Vascular surgeons
- Medical oncologists
Check below some treatment options often recommended for people according to the type of tumor:
Primary Spinal Tumor Treatment
If you have a benign tumor that does not cause symptoms, doctors often recommend surgery to remove the tumor. For example, a complete en bloc resection may cure the condition. Sometimes, when tumors develop in the spinal cord intramedullary, this procedure cannot be performed. If you develop a cancerous tumor, the following treatments are often recommended.
Secondary Spinal Tumor Treatment
Healthcare professionals may prescribe either one or a combination of the following treatments to treat metastatic spinal tumors. Examples include:
- Chemotherapy – This cancer treatment involves strong medicines used to kill cancer cells throughout the body. While you can receive these drugs intravenously (IV), a pill form is also available. Physicians often prescribe chemotherapy in the following cases. For example, before surgery to shrink a large tumor, after surgery to destroy cancer cells that may remain, when surgery is not an option, and in advanced stages of the cancer.
- Radiation therapy – This therapy delivers powerful energy to kill cancer cells. Usually, this energy comes from protons, X-rays, and other sources. It often helps relieve the symptoms caused by the tumor.
- Stereotactic radiosurgery – This is a precise, noninvasive procedure that uses beams of radiation. Moreover, it keeps the radiation to a minimum to nearby tissues.
- Surgery – Generally, doctors recommend this treatment when a person with a metastatic spinal tumor is expected to live 3-4 months or longer, and it is resistant to radiation therapy and chemotherapy. Surgery helps reduce pain and other symptoms. Doctors often perform vertebroplasty or kyphoplasty.
Frequently Asked Questions
Who gets spinal tumors?
While anyone may develop these tumors, some people are more likely to get them. These include people with lung, breast, or prostate cancers. However, primary spinal tumors occur less commonly and affect mostly older adults (between the ages of 65 and 74) and children (between the ages of 10 and 16).
What is the most common spinal tumor?
While the most common primary spinal tumors are spinal hemangiomas, the secondary type mostly occurs due to lung, prostate, or breast cancer. For more details, discuss it with your physician.
What is the survival rate for spinal tumors?
The survival rates of people with spinal tumors are different because they depend on multiple factors. For example, age, existing health problems, response to treatment, type and size of the tumor, and others. According to the American Cancer Society, the 5-year survival rate is around 36% for people with a central nervous system tumor. Ask your healthcare provider if you have additional questions.
