Spinal Tumours

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A spinal tumour is a growth in your spinal canal or within the bones of your spine that can cause pain, neurological problems and sometimes paralysis.

There are several different types of spinal tumour. Intradural spinal tumours grow in the spinal cord, or the covering of the spinal cord (the dura).

There are two main types of intradural tumours:

  • Intramedullary tumours, which grow in the cells of the spinal cord.
  • Extramedullary tumours, which grow either in the membranes surrounding the spinal cord or in the nerve roots. They may cause spinal cord compression and other problems.

Vertebral spinal tumours grow in the bones of the spine (vertebrae). The spine may also be affected by tumours from other parts of the body, which can spread (metastatic spinal tumours) to the vertebrae, the area around the spinal cord or the spinal cord itself.

Spinal tumours grow at different rates depending on the type of tumour.

Symptoms include:

  • Pain at the site of the tumour and in the back generally. This may radiate out to other parts of the body.
  • Loss of bladder or bowel function.
  • Difficulty walking, which may lead to falls.
  • Loss of sensation or muscle weakness in the arms and legs, as well as other parts of the body.
  • Reduced sensitivity to heat, cold or pain.

The most common cause of spinal tumour is metastatic. This is a tumour that originates from a primary tumour, most commonly breast, lung, prostrate, renal, thyroid and occasionally bowel, cancers.

Scientists are not completely clear why most primary spinal tumours develop. Genetic mutations are believed to play a part but it is unclear whether this is due to inherited genetic defects or genes that mutate over time.

Exposure to certain chemicals may be a contributory factor. Spinal tumours are also linked to these inherited syndromes:

Neurofibromatosis 2: A hereditary disorder that causes tumours on or near the nerves responsible for hearing. This can result in progressive hearing loss and may lead to spinal cord tumours.

Von Hippel-Lindau disease: A rare disorder that leads to blood vessel tumours in the brain, retina, spinal cord and other organs.

Spinal tumours can be overlooked because they share similar symptoms to other, more common conditions. If your doctor suspects a spinal tumour you may be offered:

  • A thorough clinical evaluation to rule out any neurological deficit, or any pre-existing or past medical history of cancer.
  • Blood tests – To exclude a high-calcium blood level.
  • A spinal MRI scan – This can produce an accurate image of your spine, spinal cord and nerves. A contrast dye that can help to highlight spinal tissues and structures may be injected into the vein of your hand or forearm during the test.
  • A CT scan – This is used less commonly than an MRI scan but may be used, with an injection of contrast dye, to identify abnormal changes in the spinal canal or spinal cord.
  • Biopsy – A small sample of tissue from the tumour will be taken and sent away to the laboratory for analysis. This will identify the type of tumour and help to determine the treatment plan.

The treatment you are offered will depend on the type and location of the tumour, as well as your age and overall health and whether the tumour has spread from other parts of your body.

While doctors will aim to eliminate the tumour completely this may not be possible due to the risk of permanent damage to the spinal cord and surrounding nerves.

A treatment plan will normally include:

  • Monitoring – If the tumour is small and isn’t growing or pressing on surrounding tissues, your doctor may recommend regular monitoring using MRI or CT scans.
  • Surgery – The advantages of surgery will need to be weighed against the risk of damage to the nerves or spinal cord. Innovative surgical techniques are being developed to treat spinal tumours, such as using high-frequency sound waves to break up the tumour and remove the fragments, or high-powered microscopes to distinguish the tumour from healthy tissue. If the tumour cannot be completely removed, you may be offered a course of radiation therapy, chemotherapy or both.
  • Radiation therapy – This may be used to eliminate any remnants of the tumour that remains after surgery or to treat inoperable tumours or tumours where surgery poses too great a risk. Adjustments may be made to the amount of radiation you are given to minimise the impact on healthy tissue and improve effectiveness. 3-D conformal radiation therapy is such a technique.
  • Chemotherapy – This uses medication to destroy cancer cells or stop them from growing. It has a range of unpleasant side effects including nausea, vomiting, increased risk of infection and hair loss. It may or may not be used alongside radiation therapy.
  • Corticosteroids – These may be prescribed to reduce inflammation either after surgery or during radiation treatment. They are normally only used for short periods to avoid potentially dangerous side-effects such as osteoporosis, diabetes, high blood pressure and susceptibility to infection.

The risk of certain types of cancers can be reduced by making lifestyle changes, however spinal tumours are not known to have lifestyle-related risk factors (such as smoking or obesity) so there is no known way to protect against them.

Spinal Tumours

A spinal tumour is a growth in your spinal canal or within the bones of your spine that can cause pain, neurological problems and sometimes paralysis.

There are several different types of spinal tumour. Intradural spinal tumours grow in the spinal cord, or the covering of the spinal cord (the dura).

There are two main types of intradural tumours:

  • Intramedullary tumours, which grow in the cells of the spinal cord.
  • Extramedullary tumours, which grow either in the membranes surrounding the spinal cord or in the nerve roots. They may cause spinal cord compression and other problems.

Vertebral spinal tumours grow in the bones of the spine (vertebrae). The spine may also be affected by tumours from other parts of the body, which can spread (metastatic spinal tumours) to the vertebrae, the area around the spinal cord or the spinal cord itself.

Spinal tumours grow at different rates depending on the type of tumour.

Symptoms include:

  • Pain at the site of the tumour and in the back generally. This may radiate out to other parts of the body.
  • Loss of bladder or bowel function.
  • Difficulty walking, which may lead to falls.
  • Loss of sensation or muscle weakness in the arms and legs, as well as other parts of the body.
  • Reduced sensitivity to heat, cold or pain.
Causes

The most common cause of spinal tumour is metastatic. This is a tumour that originates from a primary tumour, most commonly breast, lung, prostrate, renal, thyroid and occasionally bowel, cancers.

Scientists are not completely clear why most primary spinal tumours develop. Genetic mutations are believed to play a part but it is unclear whether this is due to inherited genetic defects or genes that mutate over time.

Exposure to certain chemicals may be a contributory factor. Spinal tumours are also linked to these inherited syndromes:

Neurofibromatosis 2: A hereditary disorder that causes tumours on or near the nerves responsible for hearing. This can result in progressive hearing loss and may lead to spinal cord tumours.

Von Hippel-Lindau disease: A rare disorder that leads to blood vessel tumours in the brain, retina, spinal cord and other organs.

Diagnosis

Spinal tumours can be overlooked because they share similar symptoms to other, more common conditions. If your doctor suspects a spinal tumour you may be offered:

  • A thorough clinical evaluation to rule out any neurological deficit, or any pre-existing or past medical history of cancer.
  • Blood tests – To exclude a high-calcium blood level.
  • A spinal MRI scan – This can produce an accurate image of your spine, spinal cord and nerves. A contrast dye that can help to highlight spinal tissues and structures may be injected into the vein of your hand or forearm during the test.
  • A CT scan – This is used less commonly than an MRI scan but may be used, with an injection of contrast dye, to identify abnormal changes in the spinal canal or spinal cord.
  • Biopsy – A small sample of tissue from the tumour will be taken and sent away to the laboratory for analysis. This will identify the type of tumour and help to determine the treatment plan.
Treatment

The treatment you are offered will depend on the type and location of the tumour, as well as your age and overall health and whether the tumour has spread from other parts of your body.

While doctors will aim to eliminate the tumour completely this may not be possible due to the risk of permanent damage to the spinal cord and surrounding nerves.

A treatment plan will normally include:

  • Monitoring – If the tumour is small and isn’t growing or pressing on surrounding tissues, your doctor may recommend regular monitoring using MRI or CT scans.
  • Surgery – The advantages of surgery will need to be weighed against the risk of damage to the nerves or spinal cord. Innovative surgical techniques are being developed to treat spinal tumours, such as using high-frequency sound waves to break up the tumour and remove the fragments, or high-powered microscopes to distinguish the tumour from healthy tissue. If the tumour cannot be completely removed, you may be offered a course of radiation therapy, chemotherapy or both.
  • Radiation therapy – This may be used to eliminate any remnants of the tumour that remains after surgery or to treat inoperable tumours or tumours where surgery poses too great a risk. Adjustments may be made to the amount of radiation you are given to minimise the impact on healthy tissue and improve effectiveness. 3-D conformal radiation therapy is such a technique.
  • Chemotherapy – This uses medication to destroy cancer cells or stop them from growing. It has a range of unpleasant side effects including nausea, vomiting, increased risk of infection and hair loss. It may or may not be used alongside radiation therapy.
  • Corticosteroids – These may be prescribed to reduce inflammation either after surgery or during radiation treatment. They are normally only used for short periods to avoid potentially dangerous side-effects such as osteoporosis, diabetes, high blood pressure and susceptibility to infection.
Prevention

The risk of certain types of cancers can be reduced by making lifestyle changes, however spinal tumours are not known to have lifestyle-related risk factors (such as smoking or obesity) so there is no known way to protect against them.