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Spinal cord tumor (also called an intradural tumor) is a type of spinal tumor that occurs in the spinal cord or the dura.
Spinal column is the flexible bone at the back that protects the spinal cord. Spinal cord is compose out of nerves and cells that carries impulses from the brain to the body. The bones are called vertebrae in which the spinal column is composed of 33 vertebrae, and it is divided into 5 sections, the cervical (5 vertebrae), thoracic (12 vertebrae), lumbar (5 vertebrae), sacrum (5 fused small vertebrae), and coccyx (4 fused small vertebrae). The column starts at the base of the skull and ends at the tailbone.
Spinal cord tumors are being classified based on the location of the tumor inside or outside the spinal cord. The following are the categories of spinal cord tumor.
- Intramedullary tumors – the tumor had developed within the spinal cord such as gliomas, astrocytoma or ependymoma.
- Extramedullary tumors – The tumor are located outside the spinal cord such as meningiomas, neurofibromas, nerve sheath tumors and schwannomas.
The growth of the spinal tumors could cause pain, as well as neurological deficits. If left untreated it could lead to paralysis, life-threatening conditions, and lifetime disability.
The treatment of spinal cord tumor include surgery, radiation therapy, chemotherapy, medication.
Different types of spinal tumor.
- Astrocytoma – a benign or malignant tumor of the cells inside the spinal cord.
- Chordoma – a rare malignant tumor that develop at the tailbone (coccyx) or at the skull
- Ependymoma – a tumor at the lining of the spinal fluid in the brain and spinal cord.
- Glioma – a malignant tumor that form from cells that occurs at brain at spinal cord.
- Meningioma – a benign tumor of the tissue that surrounds the spinal cord and the brain. Can be a life-threatening condition if left untreated.
- Neurofibroma – a benign tumor that develop at the spinal nerves.
- Schwannanoma – a rare benign tumor of the cells that surrounds the spinal nerves.
Symptoms
The following signs and symptoms may develop as a result of the tumor growth compressing the spinal nerves, blood vessels, or bones of the spine:
- Back pain, worsening at night
- Pain at the site where the tumor is growing
- Bowel incontinence and/or urinary incontinence
- Walking difficulties and risk of fall
- Less sensitive to heat, cold, and pain
- Loss of sensation and/or muscle weakness, especially in your arms or legs
If you notice any of the signs and symptoms that are persistent then you could make an appointment with your doctor.
Causes
Causes of the tumor have not yet determined by the specialists, but risk factors had been identified that increase the risk of having a spine tumor. Some cases may be caused by chemical or substance exposure that cause cancer.
Risk factors
Factors that may increase Spinal cord tumor risk includes.
- Neurofibromatosis 2 - a hereditary disorder, where a benign tumor developed on or surrounds the olfactory nerves. The problem may lead to hearing loss of one or both ears.
- Von Hippel-Lindau disease – a rare disorder that is associated with blood vessel tumors (hemangioblastomas) in the brain, retina and spinal cord.
Diagnosis
Spinal tumors symptoms are uncommon therefore it could be overlooked as other disease. It is important to have a consultation with the specialist for physical and neurological examinations.
The following test are used for diagnosis and the location of the tumor.
- Spinal Magnetic Resonance Imaging (MRI). Uses a strong magnetic field and radio waves to present clear images of the spine, spinal cord and nerves. It may also be done without or with a contrast agent injection for a more specific view of the tissues and structures.
- Computerized Tomography (CT) scan. A narrow radiation beam is use to produce a more detailed images of the spine.
- Tissue Biopsy. Is a removal of suspected tissue for laboratory test. The biopsy result will help determine the cell types and choose the right treatment options for the patient.
- Blood tests. Specific blood test (calcium and alkaline phosphatase) will be ordered to determine any blood abnormalities.
Treatment
The type, location and stage of cancer are some of the factors which can affect how to choose which treatment to apply aside from the general health and personal choice of treatment.
Monitoring
Spinal cord tumors may be found asymptomatic. The tumors then need to be closely observed and imaging such as CT scan or MRI must be done. If they are still small, aren’t growing and not compressing surrounding tissue, usually no intervention is needed.
Surgery
The most common treatment for spinal cord tumor is surgical removal with bearable spinal cord or nerve injury risk. Due to the modern technology and the new instruments, neurosurgeons are able to access those points that prior were inaccessible. They do this by using high-powered microscopes and performing microsurgery in order to better differentiate the tumor from healthy tissues. Neuromonitoring has been used during spinal surgery to monitor the function of the spinal cord to prevent intraoperative injury. Not all of the tumor can be removed by surgery even with all the technological innovations. Radiation or chemotherapy or both may sometimes be used after the surgery to eliminate the remaining tumor.
Radiation Therapy
After surgery there may be residual tumor left, radiation therapy uses to destroy the remaining tumors that cannot be surgically removed. If surgical treatment of tumors are too dangerous or cannot be perform, radiotherapy can be an option.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells. It also prevents the cancer cells from growing. Chemotherapy can be used alone or combined with radiation therapy. Patient may feel fatigue, nausea, vomiting, increased risk of infection and hair loss as a side effect of the treatment.
Other medications
Corticosteroids may be used in order to minimize swelling when undergoing surgery or radiation. Corticosteroid can make serious side effect such as osteoporosis, diabetic, increased risk of infection and muscle weakness.
