Spinal and spinal cord tumors are often overlooked because they are not common and their symptoms resemble those of more common conditions. However, the earlier you tell your doctor about your symptoms, get a diagnosis, and start treatment, the better your outcome is likely to be.
What is spinal and spinal cord tumors?
A spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and/or spinal column. These cells grow and multiply uncontrollably. Spinal tumors can be benign (non-cancerous) or malignant (cancerous). Primary tumors originate in the spine or spinal cord, and metastatic or secondary tumors result from cancer spreading from another site to the spine.
A spinal tumor is a growth that develops within your spinal canal or within the bones of your spine. A spinal cord tumor, also called an intradural tumor, is a spinal tumor that that begins within the spinal cord or the covering of the spinal cord (dura). The spinal column is the most common site for bone metastasis (metastatic spinal tumor). Common primary cancers that spread to the spine are lung, breast and prostate.
Not just back pain!
Symptoms of spinal and spinal cord tumors may be overlooked, because their symptoms resemble those of more-common conditions. Spinal and spinal cord tumors can cause different signs and symptoms, especially as tumors grow. Back pain is a common early symptom. If the pain does not go away after a while, you should seek an immediate medical attention.
Signs and symptoms of spinal and spinal cord tumors may include:
- Back pain – off and on, chronic
- Back pain, often radiating to other parts of your body
– Cervical spine level: neck pain, numbness or weakness radiating down your arm and hand, loss of bladder or bowel control (if severe)
– Thoracic spine level: pain in middle back region, tingling/numbness in the middle back and in areas where the affected nerve travels, loss of bladder or bowel control (if severe)
– Lumbar spine level: pain in the lower back, pain radiating to one or both legs, loss of bladder or bowel control (if severe)
- Other abnormal symptoms – weight loss, fever, anorexia
- Back pain that is worse at night, pain at the site of the tumor due to tumor growth
- The pain is not getting better when the patient receives medication. Spinal tumors progress at different rates depending on the type of tumor. If the tumor grows slowly, it can take several years to cause symptoms. If the tumor is fast-growing, the patient will have severe pain and loss of bowel or bladder control.
Metastatic spinal tumor
A spinal tumor can be a primary tumor, which means the cancer started in the spine, or secondary, which means the cancer started in other organs and spread to the spine. Most of the time, tumors in the spinal cord (intramedullary tumors) are primary tumors. Other cancers in the body can spread to the vertebral bodies or areas around the spinal cord and cause symptoms as well. Common primary cancers that spread to the spine are lung, breast, prostate, and hematologic cancers. Therefore, patients with these cancers should be monitored closely for bone metastasis.
Early diagnosis and treatment can save your life
Patients who have symptoms that are suspicious for a spinal tumor should be comprehensively evaluated by a physician. Evaluation includes a complete medical history, a physical and neurological examination, and a radiographic study of the spine. With technological advancement, the doctor can identify whether a tumor is benign or malignant and select the individualized treatment for each patient.
Moreover, MRI and CT-scan are useful diagnostic tools in order to identify the spinal structure and the lesion. If there is a tumor, the doctor will be able to remove it by a minimally invasive spine surgery (MISS). The new technique avoids significant damage to the muscles surrounding the spine. Typically, this results in less pain after surgery and a faster recovery.
If a patient has an unstable spine (the integrity of the spinal column has been compromised) due to tumor growth, the doctor can perform minimally invasive spine surgery using O-Arm and spinal navigator. The navigator’s high quality, versatile imaging provides the information the surgeon need to guide clinical decision making. It also provides additional information in challenging procedures. This reduces complications, nerve damage, pain, and recovery time.
For a patient with cancerous tumor, tumor removal by surgery (early stage), and palliative treatment (late stage) are the treatment options. But even with the latest technological advances in surgery, not all tumors can be totally removed. When the tumor cannot be removed completely, surgery may be followed by radiation therapy or chemotherapy or both. Palliative treatment may also be offered in order to increase the patient’s quality of life.
Although spinal and spinal cord tumor are rare (<1%), these conditions should not be overlooked. If you have chronic back pain or back pain with other abnormal symptoms, you should seek a medical attention immediately.
Reference: Dr. Supreecha Kapiya, a neurological surgeon at Bangkok Spine Academy, Bangkok Hospital
For more information:
Spine Center, Bangkok International Hospital
Email: [email protected]