Spinal Cord Tumors

Spinal Cord Tumors

 

Definition

A spinal cord tumor is a benign or cancerous growth in the spinal cord, between the membranes covering the spinal cord, or in the spinal canal. A tumor in this location can compress the spinal cord or its nerve roots; therefore, even a noncancerous growth can be disabling unless properly treated.

Description

The spinal cord contains bundles of nerves that carry messages betweent the brain and the body. Because the spinal cord is rigidly encased in bone, any tumor that grows on or near it can compress the nerves, and interfere in this communication. About 10,000 Americans develop spinal cord tumors each year, and about 40% of these are cancerous. Similar to brain tumors, spinal cord growths are rare.
Newly formed tumors that begin within the spinal cord are unusual, especially among children and the elderly. More typically, tumors originate elsewhere in the body and move through the bloodstream (metastasize) to the spinal cord.

Causes and symptoms

Scientists don't know what causes these tumors, although the noncancerous growths may be hereditary or present since birth.
When the tumor presses on the spinal cord, it causes symptoms including;
  • back pain
  • severe or burning pain in other parts of the body
  • numbness or cold
  • progressive loss of muscle strength or sensation in the legs
  • loss of bladder or bowel control
A tumor in the top of the spinal column can cause pain radiating from the arms or neck; a tumor in the lower spine may cause leg or back pain. If there are several tumors in different areas of the spinal cord at the same time, it may cause symptoms in a variety of spots on the body.

Diagnosis

Suspected spinal cord compression, by tumor, is a medical emergency. Prompt intervention may prevent paralysis.
If a neurological exam and review of symptoms suggest a spinal cord tumor, the doctor may order some of these additional tests:
  • MRI or CT scan
  • myelography
  • blood and spinal fluid studies
  • x rays of the spine
  • biopsy
  • radionuclide bone scan

Treatment

If the tumor is malignant and has metastasized, treatment depends on the type of the primary cancer. Surgery is usually the first step in treating benign and malignant tumors outside the spinal cord. Tumors inside the spinal cord may not be able to be completely removed with surgery. If they can not be, radiation and chemotherapy treatments may be effective. Treatment also may include pain relievers and cortisone drugs to lessen swelling around the tumor, and ease pressure on the spinal cord.

Prognosis

Early diagnosis and treatment can produce a higher success rate. Long-term survival also depends on the tumor's type, location, and size. Surgery to remove the bone around the cord can ease pressure on the spinal nerves and nerve pathways, which will usually ease pain and other symptoms; however, it may make walking more difficult. Physical therapy and rehabilitation may help.

Prevention

Since spinal cord tumors usually are the result of a cancer that has first appeared elsewhere in the body, early detection of cancer in other organs may prevent spinal cord tumors. Lifestyle changes, as stopping smoking, to lower the risk of the development of other types of cancer, may also help.

Key terms

Computed tomography scans (CT Scan) — The CT scan combines an X-ray with a computer to create a detailed picture of the spinal cord. It may help to determine the type of tumor, locate swelling or bleeding, and check results of treatment.
Magnetic resonance imaging (MRI) — MRI is an imaging technique that uses a magnetic field to scan the body's tissues and structures. It gives a better picture of tumors located near bone than does a CT scan, without the risk of radiation, and can provide a three-dimensional image of the tumor.
Myelogram — A myelogram is an x ray exam of the spinal cord, nerves and other tissues within the spinal cord that are highlighted by injected contrast dye.

Resources

Organizations

National Institute of Neurological Disorders and Stroke. P.O. Box 5801, Bethesda, MD 20824. (800) 352-9424. http://www.ninds.nih.gov/index.htm.
References in periodicals archive ?
Specifically, pure motor paresis in lower extremities, like foot drops, are first thought to be caused by traumatic damage to peroneal nerves, lumbosacral radiculopathies, spinal cord tumors or by multiple sclerosis.
the most common pediatric neoplasms are leukemia, brain and spinal cord tumors, neuroblastomas, Wilms tumors, and lymphoma, including both Hodgkin and non-Hodgkin.
Characterization of magnetic resonance images for spinal cord tumors.
Metastases were seen in nine (18%) patients, trauma in eight (16%), transverse myelitis in eight (16%), spondylosis in three (6%), spinal cord tumors (including neurofibroma, meningioma, dermoid, and astrocytoma) in four (8%), and central cause in one (2%).
Clinical experience with image-guided robotic radiosurgery (the Cyberknife) in the treatment of brain and spinal cord tumors.
1,2 They are commonly Intradural, extramedullary, accounting for approximately two-thirds of all spinal cord tumors in adults.
Ongoing work in more advanced MRI techniques, such as diffusion tensor imaging, promises to be a useful tool in characterization of pediatric spinal cord tumors.
It expands and updates coverage of all supratentorial, infratentorial, and spinal cord tumors, and adds emphasis on the biological and cytogenetic basis of disease and post-chemotherapy morbidity, including post-chemo and radiotherapy, cognitive function, and secondary malignancies.
Some of the more severe complications are visual loss secondary to optic nerve gliomas, spinal cord tumors, scoliosis, vascular lesions, and long-bone abnormalities, which sometimes necessitate amputation 7,8.
Margins are a major component of non-CNS TNM-type surgical pathology reports but are almost never a factor in brain or spinal cord tumors.
Their topics include the pathology and molecular genetics of common brain tumors, malignant gliomas in adults, low grade astrocytomas, pediatric neuro-oncology, the managing intramedullary spinal cord tumors, medical complications in the management of brain tumor, brain metastases, neoplastic meningitis, the neurotoxicity of chemotherapy, paraneoplastic disorders, and neurological complications of bone marrow and organ transplantation.
The patient felt strongly that, despite the paraplegia, her quality of life was acceptable, and she was interested in pursuing aggressive treatment of both the brain and the spinal cord tumors.