Spinal Tumour’s

A spinal tumor is an abnormal growth (mass) of cells within or surrounding your spinal cord

and/or spinal column and it can be benign (noncancerous) or malignant (cancerous). If the tumor continues to grow, it can cause damage to different tissues in your spinal column.

There are 2 general types of spinal tumours that can cause pain: primary tumours (that first develop on your spine or spinal cord ) and secondary (metastatic , result from cancer spreading from another area in your body to your spine.)Metastatic spinal tumors are much more common than primary spinal tumors.

Healthcare providers categorize spinal tumors in many ways, including:

• Where the tumor’s located along your spine (cervical, thoracic, lumbar or sacrum).
• Where the tumor’s located within your spinal column (intradural-extramedullary,intramedullary or extradural).
• If the tumor began in your spine (primary spinal tumor) or is the result of metastasisfrom cancer in another area of your body (secondary spinal tumor).
• If the tumor is benign (noncancerous) or malignant (cancerous).

Since your spinal column is a complex structure that consists of several different types of cells and tissues, there are several types of spinal tumors, some of which include:

1 – Astrocytoma: This is a tumor of the supporting cells inside of your spinal cord. There are several types of astrocytoma tumors — some are benign and some are malignant.
2 – Chordoma: These are rare malignant tumors that form in your spine and skull.
3 – Ependymoma: This is a tumor that develops in the lining of your spinal fluid passageways in your brain and spinal cord.

4 – Glioblastoma: This is an aggressive malignant tumor that forms from cells called astrocytes that support nerve cells in your spinal cord and brain.
5 – Hemangioblastoma: This is a tumor that forms from blood vessels connected to your central nervous system, including your brain and spinal cord.
6 – Meningioma: This is a tumor of the tissue (meninges) that covers your spinal cord and brain. A meningioma is usually benign, but it can grow large enough to be life-threatening.
7 – Neurofibroma: This is a benign tumor that grows on nerves in your body, which can include nerves in your spinal column. Most neurofibromas occur in association with a genetic disorder.
8 – Osteosarcoma: This is a type of bone cancer that can originate in your spine but is more common in your thigh and shin bones.
9 – Schwannoma: This is a tumor of the cells surrounding the nerve fibers of your spinal cord, peripheral nervous system and cranial nerves. Schwannomas are often benign and rarely become cancer.
10 –Spinal hemangioma: This is a tumor that forms from the tissues of blood vessels inside of your spinal column. Spinal hemangiomas are the most common primary spinal tumor and are usually benign.What types of cancer spread (metastasize) to the spine?

1 – Lung cancer. This is the most common cancer to spread to the spine in people assigned male at birth (AMAB).
2 – Breast cancer. This is the most common cancer to spread to the spine in people assigned female at birth (AFAB).

3 -Prostate cancer.Leukemia (blood cancer).
4 -Lymphoma (lymphatic system cancer).
5 – Multiple myeloma (a type of white blood cell cancer).Melanoma (skin cancer). 6 -Sarcoma (connective tissue cancer).
7 -Kidney cancer.
8 -Thyroid cancer.
9 -Cancers of your gastrointestinal tract.

These cancers most commonly metastasize (spread) to the bony part of your spinal column.

It’s not clear why most spinal tumors develop. Experts suspect that defective genes play a role. But it’s usually not known whether such genetic defects are inherited or

simply develop over time. They might be caused by something in the environment, such as exposure to certain chemicals. In some cases, however, spinal cord tumors are linked to known inherited syndromes, such as neurofibromatosis 2 and von Hippel-Lindau disease.

Spinal cord tumors are more common in people who have:

Neurofibromatosis 2 – In this hereditary disorder, benign tumors develop on or near the nerves related to hearing. This may lead to progressive hearing loss in one or both ears. Some people with neurofibromatosis 2 also develop spinal canal tumors.

Von Hippel-Lindau disease – This rare, multisystem disorder is associated with blood vessel tumors (hemangioblastomas) in the brain, retina and spinal cord and with other types of tumors in the kidneys or adrenal glands.

The symptoms of spinal tumors depend on several factors, including:- Where the tumor is in and along your spinal column ,
How big the tumor is andWhat type of tumor it is.

Some spinal tumors cause no symptoms because they’re small enough to not press on and irritate nearby tissues. However, as a tumor grows, it can cause certain symptoms, especially pain.

1 – Spinal tumour pain – Back pain is the most common symptom of both benign (noncancerous) and malignant (cancerous) spinal tumours.

Pain from a spinal tumor usually:

• Isn’t specifically associated with an injury, stress or physical activity but can get worse with strain, such as from exercise, sneezing or coughing.
• Is aching and deep.
• Starts slowly and gradually increases.
• Is persistent at night, sometimes to the point of disrupting sleep.
• Over time, becomes intense and disruptive even at rest.

Doesn’t respond to conservative pain relief therapies and medications.

Spinal tumors can also cause radicular pain, which is pain that radiates (spreads) from your spine to your hips, legs, feet or arms. Radicular pain often feels sharp and shooting.

2 – Other symptoms of spinal tumors –

• Numbness, tingling or loss of sensation in your legs, arms or chest.
• Muscle weakness in your legs, arms or chest.
• Muscle twitches or spasms
• Stiff back or neck.
• Loss of bowel and/or bladder control (bowel incontinence and urinary incontinence).
• Difficulty walking, which may cause falls.
• Scoliosis or other spinal deformity resulting from a large and/or destructive tumor.
• Paralysis that may occur in varying degrees and in different parts of your body,depending on which nerves

A thorough medical examination with emphasis on back pain and neurological deficits is the first step to diagnosing a spinal tumor. Radiological tests are required for an accurate and positive diagnosis.

1 – X-ray: Application of radiation to produce a film or picture of a part of the body can show the structure of the vertebrae and the outline of the joints. X-rays of the spine are obtained to search for other potential causes of pain, i.e. tumors, infections, fractures, etc. X-rays, however, are not very reliable in diagnosing tumors.

2 – Computed tomography scan (CT or CAT scan): A diagnostic image created after a computer reads X-rays, a CT/CAT scan can show the shape and size of the spinal canal, its contents and the structures around it. It also is very good at visualizing bony structures.

3 – Magnetic resonance imaging (MRI): A diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology. An MRI can show the spinal cord, nerve roots and surrounding areas, as well as enlargement, degeneration and tumors.

4 – Bone Scan: A diagnostic test using Technectium-99. Helpful as an adjunct for identification of bone tumors (such as primary bone tumors of the spine), infection, and diseases involving abnormal bone metabolism.

Treatment decision-making is often multidisciplinary, incorporating the expertise of spinal surgeons, medical oncologists, radiation oncologists and other medical specialists. The selection of treatments including both surgical and non-surgical is therefore made keeping in mind the various aspects of the patient’s overall health and goals of care.

1.Non-Surgical Treatments – Nonsurgical treatment options include
observation, chemotherapy and radiation therapy. Tumors that are asymptomatic or mildly

symptomatic and do not appear to be changing or progressing may be observed and monitored with regular MRIs. Some tumors respond well to chemotherapy and others to radiation therapy. However, there are specific types of metastatic tumors that are
inherently radioresistant (i.e. gastrointestinal tract and kidney): in those cases, surgery may be the only viable treatment option.

2.Surgery – In general, healthcare providers only consider surgery as an option for people with metastatic spinal tumors when they’re expected to live three to four months or

longer and the tumor is resistant to radiation or chemotherapy. Surgery can help relieve pain and other symptoms, preserve your neurologic function and stabilize your spine. Your surgeon may suggest traditional open surgery, or you might have a minimally-invasive procedure. Your surgeon may perform vertebroplasty or kyphoplasty — a procedure in which bone cement is injected into your spine after removing the tumor. These procedures provide support and stability to your spine, improve mobility and relieve pain. Up to 10% of people who have symptomatic spine metastases can be treated by surgery.