نظرة عامة
A spinal tumor is a growth that starts in or around the spine, which includes the backbone, spinal cord and nerves. These tumors make up only 2% to 4% of all primary central nervous system tumors. They are rare tumors that begin in the brain or spinal cord rather than spreading from elsewhere.
Some spinal tumors grow slowly and are noncancerous, also called benign. Others are cancerous, also called malignant, and can spread. The term "spinal tumor" covers both types, while spinal cancer usually refers to a malignant tumor that started in or spread to the spine. Spinal cord tumors are a type of spinal tumor that starts in or right next to the cord. About 95% of spinal cancers begin as tumors in other parts of the body and spread to the spine. These are called metastatic spinal tumors.
Spinal tumors can occur anywhere along the spine but are most common in the middle part of the spine behind the chest. Another common location is the lower back. Less often, they affect the neck. Rare types include chordoma and osteosarcoma.
A spinal tumor can press on the spinal cord or nerves and cause back or neck pain, weakness, numbness, or changes in walking or balance. Pain that worsens at night or when lying down can be an early sign of a spinal tumor.
Treatment depends on the tumor's size, type and location. Options may include surgery, radiation therapy or medicine. Small or slow-growing tumors may only need regular MRI monitoring.
The outlook for spinal tumors varies. Many benign tumors can be removed or monitored safely, while spinal cancers often need long-term care. Finding and treating a tumor quickly can help people stay mobile, keep their strength and protect their nerves. Treatment aims to slow or stop tumor growth and reduce pressure on the spinal cord.
Types
Spinal tumors are grouped by where they start growing in the body:
- Vertebral tumors. These begin in the bones of the spine. Benign types of vertebral tumors include osteoid osteoma and hemangioma. Malignant examples of vertebral tumors include osteosarcoma and cancers that spread to the spine from other areas of the body, also called metastatic.
- Intradural extramedullary tumors. These grow inside the covering of the spinal cord, also called the dura, but outside the cord itself. MRI is the best imaging test for finding these tumors and seeing spinal cord compression. Benign examples include meningioma, schwannoma and neurofibroma. Rare malignant examples include malignant peripheral nerve sheath tumors.
- Intramedullary tumors. These start inside the spinal cord tissue. Low-grade examples such as ependymoma tend to grow slowly and are less likely to spread. They can still cause symptoms by pressing on the cord. Malignant examples include astrocytoma and high-grade ependymoma.
الأعراض
A spinal tumor can cause different symptoms depending on where it grows and how much pressure it puts on nerves or the spinal cord. Some spinal tumors grow slowly and may not cause symptoms at first. Others cause pain or nerve symptoms early on.
The most common symptom is back or neck pain that doesn't go away. This pain may feel dull, sharp or burning. Other symptoms can include:
- Pain that gets worse at night or when lying down.
- Pain that radiates from the spine to the arms, legs, chest or hips.
- Numbness or tingling in the arms, legs, hands or feet.
- Muscle weakness or trouble walking.
- Trouble with balance or coordination.
- In severe disease, loss of bladder or bowel function.
- Reduced sensitivity to pain or temperature.
- Muscle spasms.
Not everyone has all of these symptoms. Even small tumors can cause symptoms if they press on a nerve.
How do I know whether back pain is cancer or just regular pain?
Most back pain is not caused by cancer. The cause of back pain often is something such as muscle strain, arthritis or a bulging disk. But back pain might be a sign of a spinal tumor if:
- It gets worse at night or doesn't improve with rest.
- It keeps getting worse over time.
- It comes with numbness, weakness or tingling.
- It comes with feeling very tired or weight loss that happens without trying.
- It gets worse when you cough, sneeze or strain.
- It doesn't get better with medicine.
If back pain doesn't go away after a few weeks or is getting worse, it's important to talk with a healthcare professional.
Is a lump on the back of the neck a spinal tumor?
A lump on the back of the neck can happen for many reasons. It can be a cyst, swollen lymph node or muscle knot. It usually is not a spinal tumor. Most spinal tumors grow inside the spine, so they don't form a lump you can see or feel. But if the lump keeps getting bigger, feels hard, or comes with pain, numbness or weakness, a healthcare professional should check it.
Are lesions on the spine a symptom of spinal cancer?
Lesions on the spine can be a sign of spinal cancer — especially if they are seen on an imaging test such as an MRI or a CT scan. These lesions may be tumors that started in the spine or spread from cancer in another part of the body. Not all spinal lesions are cancer though. Some may be not cancerous, also called benign. Your care team may order a biopsy or more tests to find out.
Why is spinal tumor pain worse at night?
Spinal tumor pain often feels worse at night or when lying flat. That may happen because of changes in spinal fluid pressure, less movement or less distraction from pain during sleep. Some tumors also release chemicals that cause more pain when the body is at rest. Ask your care team to look for the cause of nighttime pain that wakes you up or doesn't improve with position changes.
When to seek care
Seek care for back pain that you can't explain if it lasts more than a few weeks, gets worse over time, or doesn't improve with rest or movement.
Most back pain is not caused by cancer. But if you notice these signs, it's important to get checked. Early testing can help find the cause and prevent serious nerve damage.
الأسباب
A spinal tumor happens when cells in or around the spine start to grow out of control. These cells form a lump, known as a tumor, that can press on the spinal cord or nerves. But for many tumors, the exact cause is not known.
Some spinal tumors begin in the spine itself. These are called primary spinal tumors. Experts don't always know why they form, but they may be linked to changes in the body's genes or to rare inherited conditions.
Other spinal tumors start in another part of the body and spread to the spine. These are called metastatic or secondary tumors. These are the most common spinal tumors in adults. Cancers that often spread to the spine include:
If you've had one of these cancers, your care team may advise checking your spine if you have new back pain or nerve symptoms.
عوامل الخطورة
A risk factor is something that may increase your chances of getting a spinal tumor. Having one or more risk factors doesn't mean you will get a tumor — but it may raise the chances.
Can other cancers spread to the spine?
Yes. One of the biggest risk factors for spinal cancer is having another type of cancer that can spread to the spine, especially breast, lung, prostate, kidney and thyroid cancers. When these cancers spread to the spine, they are called metastatic spinal tumors. They make up most spinal tumors in adults.
Other risk factors for spinal tumors may include:
- Genetic conditions such as neurofibromatosis type 2 (NF2) and Von Hippel-Lindau disease, which can lead to tumors in the spine or brain. Most people with spinal tumors do not have a family history of these conditions.
- A weakened immune system, especially in people with certain infections or who take long-term immune-suppressing medicines, may increase cancer risk overall and the risk of certain lymphomas that may affect the spine.
- Previous radiation therapy, especially if it involved the head, neck or spine area, can increase the risk of future tumors in the area that was treated.
- Rarely, a family history of spinal tumors.
Many people with spinal tumors have no clear risk factors. But knowing the possible links can help with early diagnosis.
المضاعفات
Spinal tumors can cause serious symptoms if they press on the spinal cord or nerves. These complications depend on the tumor's size, location and how fast it grows. Even benign tumors can lead to complications if they're not treated.
Common complications of spinal tumors include:
- Nerve damage and spinal cord compression. This is a medical emergency. A growing tumor can press on spinal nerves or the spinal cord, causing numbness, weakness, balance trouble or, when severe, paralysis. New symptoms or fast changes need urgent evaluation by your care team.
- Back or neck pain. Pain from spinal tumors may get worse over time and may not go away with rest. Pain also can spread to the arms, legs or chest.
- Loss of movement or coordination. Tumors that affect the spinal cord can make it hard to walk, use the hands or keep balance.
- Loss of bladder or bowel function. If a tumor compresses certain nerves, it may cause trouble with bladder or bowel function. Changes in bladder and bowel function can be long lasting if not treated quickly.
- Spinal instability or fractures. Tumors in the bones of the spine can make them weaker or more likely to break, especially if the tumor is cancerous or has spread from another part of the body.
These symptoms may come on slowly or suddenly. Getting diagnosed and treated early can help prevent long-term damage and improve recovery.
الوقاية
Most spinal tumors cannot be prevented. Many spinal tumors develop without a clear cause. Some are linked to rare genetic conditions, and others start as cancer in another part of the body and later spread to the spine.
While you can't always prevent a spinal tumor, there are steps you can take to lower your overall cancer risk:
- Avoid tobacco use.
- Eat a healthy diet with plenty of fruits and vegetables.
- Exercise regularly.
- Keep a healthy weight.
- Limit alcohol use.
- Manage long-term health conditions with help from your care team.
If you have a history of cancer, regular follow up care can help find tumors that spread to the spine early — before they cause serious symptoms.
For people with a family history of rare conditions such as neurofibromatosis type 2 (NF2) or Von Hippel-Lindau disease, genetic counseling may be helpful.
There is no guaranteed way to prevent spinal tumors. But staying aware of symptoms and keeping up with routine care can make a difference in catching tumors early.