Spinal Tumor

Overview

A spinal tumor is an abnormal mass of cells that grows within or around the spinal cord or the bones (vertebrae) that make up the spine. Spinal tumors can be benign (non-cancerous) or malignant (cancerous). They are classified by where they sit relative to the spinal cord and its coverings, which affects the symptoms they cause and how they are treated.

Some spinal tumors begin in the spine itself (primary tumors), but many are cancers that have spread to the spine from another part of the body, such as the breast, lung, or prostate (metastatic tumors). Because the spine houses the spinal cord and the nerves branching from it, even a non-cancerous growth can cause serious problems by pressing on these structures. Early recognition and treatment are important to relieve pressure and protect nerve function.

Symptoms

Symptoms depend on the tumor's size and location but often relate to pressure on the spinal cord or nerves:

• Back or neck pain, which may be worse at night, with rest, or when lying down
• Pain that spreads to the arms, legs, hips, or chest
• Numbness, tingling, or weakness in the limbs
• Difficulty walking or a loss of balance, with a tendency to fall
• Reduced sensitivity to heat, cold, or pain
• Loss of bladder or bowel control in more advanced cases

Back pain that is persistent, progressive, not related to activity, or worse at night deserves prompt evaluation.

Causes

In most cases the cause of a primary spinal tumor is unknown. Some are linked to inherited conditions that predispose people to tumors of the nervous system. Other spinal growths are the result of cancer that has spread from elsewhere in the body.

• Metastatic tumors: Cancers that travel to the spine from organs such as the breast, lung, prostate, or kidney; these are the most common spinal tumors in adults.
• Primary tumors: Growths that start in the spinal cord, its coverings, or the vertebrae, which may be benign or cancerous.

Certain genetic syndromes raise the risk of developing tumors of the spinal cord and nerves.

Risk Factors

• A current or past cancer that can spread to the spine
• Inherited conditions such as neurofibromatosis or von Hippel-Lindau disease
• A weakened immune system
• Previous radiation exposure in some cases

For many people with a primary spinal tumor, no clear risk factor is found.

Diagnosis

Diagnosis combines a neurological assessment with imaging and, often, tissue testing:

• Neurological examination: Checking strength, sensation, reflexes, and coordination.
• MRI of the spine: The most detailed test to show the tumor and its effect on the spinal cord and nerves.
• CT scan: To evaluate the bones of the spine.
• Biopsy: Taking a tissue sample to determine whether the tumor is benign or cancerous and what type it is.
• Additional imaging: To look for a primary cancer elsewhere if a metastatic tumor is suspected.

Treatment

Treatment depends on the tumor type, location, and whether it is cancerous, and often involves a team of specialists:

• Monitoring: Small, slow-growing benign tumors that cause no symptoms may simply be watched.
• Surgery: To remove the tumor or relieve pressure on the spinal cord and nerves, when it can be done safely.
• Radiation therapy: To shrink or control tumors, including those that cannot be fully removed and many metastatic tumors.
• Chemotherapy or targeted therapy: For certain cancerous tumors, often alongside other treatments.
• Corticosteroids: To reduce swelling and ease pressure around the spinal cord.

Rehabilitation may follow treatment to help recover strength and function.

Prevention

Most spinal tumors cannot be prevented because their causes are not fully understood. Steps that may help with early detection and overall risk include:

• Attending recommended cancer screenings and follow-up if you have a history of cancer
• Seeking genetic counseling if you have an inherited condition that raises tumor risk
• Reporting persistent or night-time back pain and new neurological symptoms promptly

When to See a Doctor

See a doctor for back or neck pain that is persistent, progressive, worse at night or with rest, or not related to activity, especially if you have a history of cancer. Seek emergency care immediately if you have:

• New or rapidly worsening weakness in the arms or legs
• Numbness in the groin or inner thighs
• Loss of bladder or bowel control
• Sudden difficulty walking

These can signal spinal cord compression, which needs urgent treatment.

Related Topics

Frequently Asked Questions

References

1. National Cancer Institute (NCI). Spinal cord tumors.
2. American Association of Neurological Surgeons (AANS). Spinal Tumors.
3. Mayo Clinic. Spinal tumors.
4. MedlinePlus, U.S. National Library of Medicine. Spinal tumor.