A spinal tumor is a growth of cells (mass) in or surrounding the vertebral column and spinal cord. The most common malignant spinal tumor is metastatic disease from a distant cancer.
Any type of tumor may occur in the spine, including:
A small number of spinal tumors occur in the nerves of the spinal cord itself. Most often these are ependymomas and other gliomas.
Tumors that start in spinal tissue are called primary spinal tumors. Tumors that spread to the spine from some other place (metastasis) are called secondary spinal tumors. Tumors spread to the spine most commonly from the breast, prostate, lung, and other areas.
The cause of primary spinal tumors is unknown. Some primary spinal tumors occur with genetic defects.
Spinal tumors can occur:
Inside the spinal cord (intramedullary)
In the membranes (meninges) covering the spinal cord (extramedullary - intradural)
Between the meninges and bones of the spine (extradural)
Or, tumors may extend from other locations. Most spinal tumors are extradural.
As it grows, the tumor can affect the:
Bones of the spine
Spinal cord cells
The tumor may press on the spinal cord or nerve roots, causing damage. With time, the damage may become permanent.
The symptoms depend on the location, type of tumor, and your general health. Tumors that have spread to the spine from another site (metastatic tumors) often progress quickly. Primary tumors often progress slowly over weeks to years.
Tumors in the spinal cord usually cause symptoms, sometimes over large portions of the body. Tumors outside the spinal cord may grow for a long time before causing nerve damage.
Symptoms may include:
Abnormal sensations or loss of sensation:
Especially in the legs (may be in the knee or ankle, with or without shooting pain down the leg)
Cold sensation of the legs, cool fingers or hands, or coolness of other areas
Gets worse over time
In any area -- middle or low back are most common
Is usually severe and not relieved by pain medication
Is worse when lying down
Is worse with strain, cough, sneeze
May extend to the hip, leg, or feet (or arms), or all extremities
Inability to keep from leaking urine (urinary incontinence)
Muscle contractions, twitches, or spasms (fasciculations)
Muscle function loss
Muscle weakness (decreased muscle strength not due to exercise):
Especially in the legs
Makes walking difficult
May get worse (progressive)
Exams and Tests
A neurological examination may help pinpoint the location of the tumor. The surgeon may also find the following during an exam:
Increased muscle tone
Loss of pain and temperature sensation
Tenderness in the spine
These tests may confirm spinal tumor:
Spine MRI with contrast
Cerebrospinal fluid (CSF) examination
Cytology (cell studies) of CSF
Treatment depends on tumor type and location. The goal of treatment is to reduce or prevent nerve damage from pressure on (compression of) the spinal cord.
Treatment should be given quickly. The more quickly symptoms develop, the sooner treatment is needed to prevent permanent injury. Any new or unexplained back pain in a patient with cancer should be thoroughly investigated.
Nerve damage often continues, even after surgery. Although some amount of permanent disability is likely, treatment may delay major disability and death.
Life-threatening spinal cord compression
Loss of sensation
Permanent damage to nerves, disability from nerve damage