概述

脊柱肿瘤是一种累及脊柱骨骼或椎骨的脊柱肿瘤。起源于脊髓或脊髓骨膜层(硬脑膜)的脊柱肿瘤称作脊髓肿瘤。

累及椎骨的肿瘤通常是因身体其他部位的癌症扩散(转移)而来。但也有一些类型的肿瘤起源于脊柱骨骼,例如脊索瘤、软骨肉瘤、骨肉瘤、浆细胞瘤和尤因氏肉瘤。

脊柱肿瘤可能因压迫脊髓或附近神经根而累及神经功能。因为这些肿瘤在骨骼内生长,可能还会引起疼痛、椎骨骨折或脊柱不稳。

无论是不是癌性,脊柱肿瘤都可能危及生命和永久致残。

脊柱肿瘤有多种治疗方案可选,包括手术、放射疗法、化疗、药物治疗,或者仅仅监测肿瘤变化。

症状

脊柱肿瘤可能引发各种体征和症状,尤其是在肿瘤生长期间。肿瘤可能累及脊髓或神经根、血管或脊椎骨。脊柱肿瘤的体征和症状可能包括:

  • 肿瘤生长导致肿瘤部位疼痛
  • 背痛,通常辐射至身体其他部位
  • 晚间背痛加剧
  • 失去知觉或者肌无力,尤其是手臂或腿部
  • 行走困难,有时会跌倒
  • 感觉对冷、热和疼痛的敏感程度降低
  • 丧失肠道和膀胱功能
  • 瘫痪的程度可轻可重,可能在身体的不同部位出现

脊柱肿瘤的发展速度取决于肿瘤的类型。

何时就诊

背痛的原因很多,但多数背痛不是由肿瘤引起的。但是早期诊断和治疗对椎骨肿瘤至关重要,因此,如果出现以下情况,请就诊检查背痛问题:

  • 背痛持续且越来越严重
  • 与运动无关
  • 夜间加重
  • 您有癌症史,并出现新的背痛
  • 您出现癌症的其他全身性体征和症状,如恶心、呕吐或头晕

如果您出现以下情况,请立即就医:

  • 腿部或手臂渐进性肌无力或麻木
  • 排便或排尿习惯改变

病因

起源于脊柱的椎骨肿瘤非常罕见,尚不清楚其发病原因。专家怀疑缺陷基因是其中一个因素。但是,通常不知道此类基因缺陷是遗传而来还是随着时间逐渐产生的。或者,可能会由环境中的因素导致,例如接触某些化学品。

大多数椎骨肿瘤是转移性的,这意味着它们从身体其他器官中的肿瘤扩散而来。任何类型的癌症都可能转移到脊柱,但是从乳腺、肺部和前列腺扩散而来的常见肿瘤比其他肿瘤更有可能扩散到脊柱。骨癌,例如多发性骨髓瘤,也可能扩散到脊柱。

椎骨肿瘤在有过癌症史的人群中也更常见。

风险因素

The risk of vertebral tumors is higher in people who have cancer or have been treated for cancer. Most vertebral tumors are caused by cancer that starts somewhere else in the body and spreads to the spine. Cancer that spreads to the spine most often starts in the breasts, lungs or prostate.

并发症

非癌性和癌性椎骨肿瘤均可能压迫脊神经,导致肿瘤部位下方的运动或感觉丧失。这有时可能会引起肠道和膀胱功能的变化。其所造成的神经损伤可能是永久性的。

此外,脊柱肿瘤还可能损害脊柱的骨骼并导致其不稳定,从而增加脊柱突然骨折或塌陷的风险,继而对脊髓造成损伤。

但是,如果及早发现并积极治疗,则有可能防止功能进一步丧失并恢复神经功能。压迫脊髓的肿瘤可能会危及生命,具体取决于肿瘤所在的位置。

Nov. 14, 2020
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