Spinal Tumors
Introduction
Spinal tumors grow within the spinal column or actually in the
spinal cord, and are rare. Primary spinal tumors (those starting
in the spine) are most rare and tend to occur in young adults. A
physician may investigate for spinal tumor or spinal infection if
the patient has the following symptoms:
- Back or neck pain accompanied by nausea, vomiting, loss of appetite,
weight loss, chills, fever or night sweats
- Back or neck pain that does not improve with rest.
- Back or neck pain that is worse at night.
- Pain in a specific, well-defined area of the back that is worse
in the morning.
- Back or neck pain accompanied by neurological symptoms such
as numbness or weakness of the arms or legs, or change in the
bowel or bladder routine.
What are the types of spinal tumors?
Spinal tumors can be benign (non-cancerous) or malignant (cancerous).
Metastatic spinal tumors are those that spread (metastasize) from
another cancer in another area of the body. See "Spinal Malignancy"
for information on metastatic cancerous tumors.
Intradural-Extramedullary Tumors
Intradural-extramedullary tumors grow in the spinal canal between
the dura (the tough covering over the nerve) and the spinal nerve.
Although usually benign and slow-growing, they can cause pain and
weakness. Two types of these tumors are meningiomas and nerve sheath
tumors (such as schwannomas and neurofibromas).
Intramedullary Tumors
Intramedullary tumors grow inside the spinal cord or individual
nerves and occur most frequently in the cervical (neck) spinal cord.
Astrocytomas and ependymomas are the two most common types. Although
usually benign, they are difficult to remove. Intramedullary lipomas
are rare congenital tumors most commonly located in the thoracic
spinal cord. These tumors are not neoplasms; these tumors are like
normal adipose (fat) tissue. They increase in size and in relation
to fatty tissue elsewhere in the body.
What causes spinal tumors?
The causes of primary spinal tumors are uncertain.
Can spinal tumors be prevented?
Without a known cause, prevention of primary spinal tumors is unknown.
Fortunately, they are not common.
What treatment options are there for spinal tumors?
The goal for treatment of non-malignant spinal tumors is to remove
the tumor, preserve neurological function, control pain and provide
structural stability to the spine. Surgical removal of spinal tumors
is delicate, since the spinal cord and nerves are very sensitive
to injury. The surgical procedure depends on the patient's general
condition, the extent of the tumor and its location.
Kyphoplasty
This surgical technique for reinforcing a vertebral body after
the draining a cystic tumor involves restoring the vertebral height
and injecting bone cement. A fluoroscope (an X-ray type machine)
is used to view the spine. Guided by the fluoroscope, the doctor
places a special needle directly into the collapsed vertebra.
Once the needle is properly placed, other instruments, including
a special balloon, are passed into the vertebra. The balloon is
then inflated by filling it with liquid solution.
The inflated balloon opens up a small cavity in the collapsed bone.
Once this has been achieved, the balloon is deflated and withdrawn.
Bone cement is then inserted into the void created by the balloon.
As the bone cement hardens, a solid support for the vertebra is
created.
The procedure lasts about 1 hour and can lead to a significant
reduction in pain caused by vertebral fracture/collapse.
Bone Cementing
After tumor removal, an epoxy cement is injected into fractured
vertebrae. The epoxy becomes rock-hard within minutes, yet is
light and supportive. This strengthens the vertebra, reducing
the chance of collapse after removal of the tumor. The vertebrae
must be treated before total collapse. Other injectable bone-mineral
substitutes that are similar to normal bone are being tested.
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John
J. Regan, M.D.