Spinal tumor consultation
The spinal cord is housed within the spinal canal, a hollow chamber within the vertebrae (spinal canal). It extends from the base of the skull to the lower back.
A vertebral tumor is a type of spinal tumor affecting the bones or vertebrae of the spine. Spinal tumors that begin within the spinal cord or the covering of the spinal cord (dura) are called spinal cord tumors.
Tumors that affect the vertebrae have often spread (metastasized) from cancers in other parts of the body. But there are some types of tumors that start within the bones of the spine, such as chordoma, chondrosarcoma, osteosarcoma, plasmacytoma and Ewing's sarcoma.
A vertebral tumor can affect neurological function by pushing on the spinal cord or nerve roots nearby. As these tumors grow within the bone, they may also cause pain, vertebral fractures or spinal instability.
Whether cancerous or not, a vertebral tumor can be life-threatening and cause permanent disability.
There are many treatment options for vertebral tumors, including surgery, radiation therapy, chemotherapy, medications or sometimes just monitoring the tumor.
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Types of vertebral tumors
The spinal anatomy of a typical adult
Your spine is made up of small bones (vertebrae) stacked on top of one another that enclose and protect the spinal cord and its nerve roots.
Vertebral tumors are classified according to their location in the spine or vertebral column. Vertebral tumors are also known as extradural tumors because they occur outside the spinal cord itself.
Most tumors that affect the vertebrae have spread (metastasized) to the spine from another place in the body — often the prostate, breast, lung or kidney. Multiple myeloma is a type of cancer that often metastasizes to the spine. Although the original (primary) cancer is usually diagnosed before back problems develop, back pain may be the first symptom of disease in people with metastatic vertebral tumors.
Tumors that begin in the bones of the spine (primary tumors) are far less common. Plasmacytoma is one type of primary vertebral tumor.
Other tumors, such as osteoid osteomas, osteoblastomas and hemangiomas, also can develop in the bones of the spine.
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Vertebral tumors can cause different signs and symptoms, especially as tumors grow. The tumors may affect your spinal cord or the nerve roots, blood vessels, or bones of your spine. Vertebral tumor signs and symptoms may include:
- Pain at the site of the tumor due to tumor growth
- Back pain, often radiating to other parts of your body
- Back pain that's worse at night
- Loss of sensation or muscle weakness, especially in your arms or legs
- Difficulty walking, sometimes leading to falls
- Feeling less sensitive to cold, heat and pain
- Loss of bowel or bladder function
- Paralysis, which may be mild or severe, and can strike in different areas throughout the body
Spinal tumors progress at different rates depending on the type of tumor.
When to see a doctor
There are many causes of back pain, and most back pain isn't caused by a tumor. But because early diagnosis and treatment are important for vertebral tumors, see your doctor about your back pain if:
- It's persistent and progressive
- It's not activity related
- It gets worse at night
- You have a history of cancer and develop new back pain
- You have other systemic signs and symptoms of cancer, such as nausea, vomiting or dizziness
Seek immediate medical attention if you experience:
- Progressive muscle weakness or numbness in your legs or arms
- Changes in bowel or bladder function
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Vertebral tumors that begin in the spine are very rare, and it's not clear why they 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. Or, they might be caused by something in the environment, such as exposure to certain chemicals.
Most vertebral tumors are metastatic, which means they have spread from tumors in organs elsewhere in the body. Any type of cancer can travel to the spine, but common tumor spread from the breast, lung and prostate are more likely than others to spread to the spine. Cancers of the bone, such as multiple myeloma, also may spread to the spine.
Vertebral tumors are also more common in people who have a prior history of cancer.
Both noncancerous and cancerous vertebral tumors can compress spinal nerves, leading to a loss of movement or sensation below the location of the tumor. This can sometimes cause changes in bowel and bladder function. Nerve damage may be permanent.
A vertebral tumor may also damage the bones of the spine and make it unstable, which raises the risk of a sudden fracture or collapse of the spine that could injure the spinal cord.
However, if caught early and treated aggressively, it may be possible to prevent further loss of function and regain nerve function. Depending on its location, a tumor that presses against the spinal cord itself may be life-threatening.
Nov. 14, 2020