Spinal Tumors

Spinal tumors can be benign (non-cancerous) or malignant (cancerous). They are often referred to by the region of the spine in which they occur: cervical, thoracic, lumbar and sacrum.

Primary tumors originate in the spine or spinal cord. Metastatic or secondary tumors are more common and result from cancer spreading from another site to the vertebrae, the supporting area around the spinal cord or, in rare cases, the spinal cord itself. Each category of spinal tumor is further classified based on the type of cells in the tumor.

Spinal tumors or growths of any kind can lead to pain, neurological problems and sometimes paralysis. They often can be life-threatening or cause permanent disability. However, if caught early and treated aggressively it may be possible, in some cases, to prevent further loss of function and regain nerve function.

It is still unknown why spinal tumors develop. Environment, defective genes or exposure to certain chemicals are suspected.

About 10,000 Americans develop primary or metastatic spinal cord tumors each year. In fact, the spinal column is the most common site for bone metastasis. It is estimated that cancer spreads to the spine of between 30 to 70 percent of cancer patients.

The most common primary cancers that spread to the spine are lung, breast, and prostate but other cancers can also spread to this area.

Prompt diagnosis and identification of the primary malignancy are crucial to overall treatment. There are many other factors that can affect outcome and demand consideration in determining treatment.

Pediatric Spinal Tumors:

Primary spinal tumors are rare in children and are challenging to treat. Children’s bones and bodies are still in development and experiencing growth spurts, so they must be treated much differently than adults. Spinal stability, surgical versus nonsurgical interventions and preservation of neurological function are important considerations.

Because of a working relationship with St. Jude Children’s Research Hospital, the physicians at Semmes Murphey Clinic are some of the most experienced in the world in pediatric tumor surgery.

Adult and pediatric cancer patients can benefit from the highly specialized, multi-disciplinary team of neurology and oncology surgeons at Semmes Murphey Clinic. Along with a comprehensive, evidence-based approach to cancer surgery and treatment, their goal is to address the unique needs of each patient.

Because there are so many different possible tumor locations in and around the spinal cord, signs, and symptoms can also be different.

The most common is a pain in the neck or back. It usually builds gradually and worsens over time. This pain may spread beyond the back to the hips, legs, feet or arms and may worsen over time.

In addition, other common spinal tumor symptoms include:

• Weakness or numbness in the arms, legs or chest area
• Difficulty walking or standing, sometimes leading to falls
• General loss of sensation throughout the body
• Loss of bladder or bowel control
• Feeling less sensitive to pain, heat, and cold
• Back pain that's worse at night
• Muscle weakness, which may be mild or severe, in your arms or legs or other parts of your body

It’s important to note that there are many causes of back pain other than a spinal tumor. But because early diagnosis and treatment are so important for spinal tumors, make an appointment to see a doctor if your back pain is:

• Persistent and progressive — even when treated by conservative, nonsurgical methods that can often help alleviate back pain attributed to mechanical causes,
• Not related to activity or an injury,
• Worse at night,

Or if you have a:

• History of cancer and develop new back pain, or
• Other symptoms of cancer, such as nausea, vomiting or dizziness.

As the oldest, most comprehensive neuro-oncology surgery center in the region, Semmes Murphey Clinic team members have extensive experience in treating even the rarest types of spinal tumors.

From diagnosis to treatment, SMC provides a variety of specialists and advanced treatment options. Keeping in mind the unique lifestyle and health of each patient, the Semmes Murphey team uses a multidisciplinary approach to determine and implement the appropriate treatment for each case.

To properly diagnose the spinal tumor and its specific type, the physician will begin with a thorough medical examination with emphasis the patient’s medical history, back pain and other symptoms as well as any neurological issues. This is especially important as spinal tumors are uncommon and their symptoms resemble those of more common conditions.

The physician may order a variety of radiological tests during both the diagnosis and treatment phases, including:

• X-ray: Radiation is used to produce a picture of the spinal vertebrae and the outline of the joints. These also show any other potential causes of pain, such as tumors, infections, fractures, etc.
• Computed tomography scan (CT or CAT scan): This diagnostic image can show the shape and size of the spinal canal, its contents and the structures around it.
• Magnetic resonance imaging (MRI): Using powerful magnets and computer technology, this test produces three-dimensional images of body structures to show the spinal cord, nerve roots, and surrounding areas, as well as any tissue enlargement or tumors.

If these tests produce confirmation of a tumor, the next phase is usually a biopsy procedure to extract and examine a small tissue sample from the tumor. This will help determine whether the tumor is benign or malignant. If the tumor is malignant, a biopsy also helps identify cancer type, which determines treatment options.

In further investigation, a doctor may order a whole-body scan and other laboratory tests.

Treatment recommendations at Semmes Murphey Clinic are often multidisciplinary, incorporating the expertise of spinal surgeons, medical oncologists, radiation oncologists, and other medical specialists. The selection of treatments—both surgical and non-surgical—is made with the patient and with the facts at hand including the patient’s history, overall health and lifestyle goals in mind.

In the case of primary tumors, the goal is to remove the tumor completely, leading optimally to the potential cure of the malignancy.

Nonsurgical Treatment Options:

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 resistant to these treatments. In those cases, surgery may be the only viable treatment option.

Surgical Treatment Options:

Ideally, the goal of spinal tumor treatment is to eliminate the tumor completely. This goal may be complicated by the risk of permanent damage to the spinal cord and surrounding nerves. Doctors also must consider the patient’s age and overall health as well as the type of tumor and other characteristics when determining a treatment plan.

Treatment recommendations for spinal tumors may include radiation therapy, chemotherapy, biological response modifiers and/or a surgical procedure, such as:

• Resection – The removal of as much of a tumor as is safely possible to relieve neural pressure and alleviate symptoms.
• Needle-guided biopsy/needle aspiration – Sometimes recommended if a tumor cannot be removed safely.
• Complex spinal cancer surgery – The removal of a tumor to alleviate pressure and decompress the spinal cord and then reconstruct the spine.
• Spinal stabilization – An important part of any spinal tumor treatment, this procedure can sometimes be performed using minimally invasive techniques, such as endoscopy. There are a number of different methods to stabilize or cushion the vertebrae within the spine.
• Biopsy combined with the placement of cement – If the tumor has caused vertebral fractures, the surgical placement of cement can help to stabilize the spine.
• Kyphoplasty – Employed to alleviate pain, stabilize vertebrae and restore lost vertebral body height resulting from spinal fractures that were caused by a tumor.
• Focused radiofrequency ablation – A radiofrequency probe used to destroy spinal tumor cells through the application of heat.

As one of the premiere neuro-surgery centers in the world, the surgeons at Semmes Murphey Clinic have the benefit of innovative technologies and systems to help precisely locate and remove small and deep-seated tumors while preserving the surrounding bone and tissue.

Newer techniques and instruments allow neurosurgeons to reach tumors that were once considered inaccessible. Today’s high-powered microscopes used in microsurgery make it easier to distinguish tumors from healthy tissue.

At Semmes Murphey Clinic, doctors can also monitor the function of the spinal cord and other important nerves during surgery, to minimize the chance of injuring them. In some instances, very high-frequency sound waves might be used during surgery to break up tumors and remove the fragments.

But even with the latest technological advances in surgery, not all tumors can be totally removed. When the tumor can't be removed completely, surgery may be followed by radiation therapy, chemotherapy or both.

A required period of post-surgery physical rehabilitation may involve a stay in a rehabilitation hospital for a period of time. In other cases, physical therapy may take place at an outpatient facility or at the patient's home. The total recovery time after surgery may be as short as three months or as long as one year, depending on the complexity of the surgery and the patient's overall health.

The physicians of Semmes Murphey Clinic have been at the forefront of neuro-surgical advances and will continue to move forward to discover, implement and perfect new medical advances and treatments in neurology and oncology surgery.

This information was provided by the specialists at Semmes Murphey Clinic. Readers are encouraged to research trustworthy organizations for information. Please talk with your physician for websites and sources that will enhance your knowledge and understanding of this issue and its treatments.