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Spinal tumor

Overview | Causes | Symptoms | Diagnosis | Treatment | FAQ

Overview

Spinal cord tumors are abnormal growths of tissue found inside the bony spinal column, which is one of the primary components of the central nervous system (CNS). Benign tumors are noncancerous, and malignant tumors are cancerous. The CNS is housed within rigid, bony quarters (i.e., the skull and spinal column), so any abnormal growth, whether benign or malignant, can place pressure on sensitive tissues and impair function. Tumors that originate in the brain or spinal cord are called primary tumors.

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Causes

Most primary tumors are caused by out-of-control growth among cells that surround and support neurons. In a small number of individuals, primary tumors may result from specific genetic disease (e.g., neurofibromatosis, tuberous sclerosis) or from exposure to radiation or cancer-causing chemicals. The cause of most primary tumors remains a mystery. They are not contagious and, at this time, not preventable.

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Symptoms

Spinal cord tumor symptoms include pain, sensory changes, and motor problems. Symptoms generally develop slowly and worsen over time unless they are treated. Tumors within the spinal cord usually cause symptoms over large areas of the body, while tumors outside the spinal cord may grow for some time before causing nerve damage. Other symptoms include back pain, loss of sensation, muscle weakness, incontinence and muscle spasms.

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Diagnosis

The first test to diagnose brain and spinal column tumors is a neurological examination. Special imaging techniques (computed tomography, magnetic resonance imaging, positron emission tomography) are also employed. Laboratory tests include the EEG and the spinal tap. A biopsy, a surgical procedure in which a sample of tissue is taken from a suspected tumor, helps doctors diagnose the type of tumor.

The tumor may be classified as benign or malignant and given a numbered score that reflects how malignant it is. This score can help doctors determine how to treat the tumor and predict the likely outcome, or prognosis, for the patient.

spine surgeon looking at mri at Georgia Neurological Surgery & Comprehensive Spine

Outlined below are some of the diagnostic tools that your physician may use to gain insight into your condition and determine the best treatment plan for your condition.

  • Medical history: Conducting a detailed medical history helps the doctor better understand the possible causes of your back and neck pain which can help outline the most appropriate treatment.

  • Physical exam: During the physical exam, your physician will try to pinpoint the source of pain. Simple tests for flexibility and muscle strength may also be conducted.

  • X-rays are usually the first step in diagnostic testing methods. X-rays show bones and the space between bones. They are of limited value, however, since they do not show muscles and ligaments.

  • MRI (magnetic resonance imaging) uses a magnetic field and radio waves to generate highly detailed pictures of the inside of your body. Since X-rays only show bones, MRIs are needed to visualize soft tissues like discs in the spine. This type of imaging is very safe and usually pain-free.

  • CT scan/myelogram: A CT (computed tomography) scan is similar to an MRI in that it provides diagnostic information about the internal structures of the spine. A myelogram is used to diagnose a bulging disc, tumor, or changes in the bones surrounding the spinal cord or nerves. A local anesthetic is injected into the low back to numb the area. A lumbar puncture (spinal tap) is then performed. A dye is injected into the spinal canal to reveal where problems lie.

  • PET scan: A PET (positron emission tomography) is a test that uses a special camera and a tracer to look at organs in the body. The tracer is typically a substance, such as glucose, that can be used by cells in the body. The tracer liquid is inserted intravenously into the arm and moves through the body, and much of it is collected in the organs or tissues. The tracer gives off tiny positively charged particles or positrons. The special camera records the positrons and turns the recording into pictures on a computer. Because the pictures show only the location of the tracer, these pictures do not show as much detail as computed tomography (CT) scans or magnetic resonance imaging (MRI). In some cases, the PET scan may be matched with a CT scan to get more detailed information about where the tracer is located.

  • Electrodiagnostics: Electrical testing of the nerves and spinal cord may be performed as part of a diagnostic workup. These tests, called electromyography (EMG) or somatosensory evoked potentials (SSEP), assist your doctor in understanding how your nerves or spinal cord are affected by your condition.

  • Bone scan: Bone imaging is used to detect infection, malignancy, fractures and arthritis in any part of the skeleton. Bone scans are also used for finding lesions for biopsy or excision.

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Treatment

The goal when treating spinal cord tumors is to minimize nerve damage related to compression of the spinal cord. The main priority is to administer treatment as quickly as possible to prevent progression. The three most commonly used treatments are surgery, radiation, and chemotherapy. Doctors also may prescribe steroids to reduce the swelling inside the central nervous system.

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FAQs

What are some of the symptoms of spinal cord tumors?

  • Numbness in the legs that is worsening
  • Back pain
  • Incontinence
  • Muscle spasms
  • Cold feeling in the legs or hands

What is the prognosis?

The earlier the spinal cord tumor is detected, the better the prognosis. Without treatment, spinal tumors can lead to serious disability, paralysis and death.

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