Spinal Tumours

Introduction

A spinal tumor is an abnormal growth of tissue within or around the spinal cord and column, which can be benign or malignant. While the exact causes of these tumors are often unknown, factors like genetics and compromised immune systems might contribute. Symptoms include non-mechanical back pain, muscle weakness, and sensory loss. Diagnosis involves medical exams and radiological tests like CT and MRI scans. Treatment decisions, involving surgery, chemotherapy, and radiation therapy, are tailored to the tumor type and patient’s health. The Spine Clinic, led by Dr. Priyank Patel , specializes in spinal tumor treatment in Thane , providing comprehensive care and expert guidance.

What are Spinal Tumours?

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, seemingly unchecked by the mechanisms that control normal cells. 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.

Causes of Spinal Tumours

The cause of most primary spinal tumors is unknown. Some of them may be attributed to exposure to cancer-causing agents. Spinal cord lymphomas, which are cancers that affect lymphocytes (a type of immune cell), are more common in people with compromised immune systems. There appears to be a higher incidence of spinal tumors in particular families, so there is most likely a genetic component.

In a small number of cases, primary tumors may result from presence of these two genetic diseases:

Neurofibromatosis Type 2: In this hereditary (genetic) disorder, benign tumors may develop in the arachnoid layer of the spinal cord or in the supporting glial cells. However, the more common tumors associated with this disorder affect the nerves related to hearing and can inevitably lead to loss of hearing in one or both ears.
Von Hippel-Lindau disease: This rare, multi-system disorder is associated with benign blood vessel tumors (hemangioblastomas) in the brain, retina and spinal cord, and with other types of tumors in the kidneys or adrenal glands.

Symptoms of Spinal Tumours

Non-mechanical back pain, especially in the middle or lower back, is the most frequent symptom of both benign and malignant spinal tumors. This back pain is not specifically attributed to injury, stress or physical activity. However, the pain may increase with activity and can be worse at night when lying down. Pain may spread beyond the back to the hips, legs, feet or arms and may worsen over time — even when treated by conservative, nonsurgical methods that can often help alleviate back pain attributed to mechanical causes. Depending on the location and type of tumor, other signs and symptoms can develop, especially as a tumor grows and compresses on the spinal cord, the nerve roots, blood vessels or bones of the spine.
Additional symptoms can include the following:
• Loss of sensation or muscle weakness in the legs, arms or chest
• Stiff neck or back
• Pain and/or neurologic symptoms (such as tingling) increase with Valsalva maneuver
• Difficulty walking, which may cause falls
• Decreased sensitivity to pain, heat and cold
• Loss of bowel or bladder function
• Paralysis that may occur in varying degrees and in different parts of the body, depending on which nerves are compressed
• Scoliosis or other spinal deformity resulting from a large and/or destructive tumor

How are Spinal Tumours Diagnosed?

A thorough medical examination with emphasis on back pain and neurological deficits is the first step to diagnosing a spinal tumor. Radiological tests are required for an accurate and positive diagnosis.
• Computed tomography scan (CT or CAT scan)
• Magnetic resonance imaging (MRI)
• Bone Scan: A diagnostic test using Technectium-99. Helpful as an adjunct for identification of bone tumors (such as primary bone tumors of the spine), infection, and diseases involving abnormal bone metabolism.

Radiology studies noted above provide imaging findings that suggest the most likely tumor type. In some cases, however, a biopsy may be needed if diagnosis is unclear or if concern for malignancy vs benign tumor type. If the tumor is malignant, a biopsy also helps determine the cancer’s type, which subsequently determines treatment options.
Staging classifies neoplasms (abnormal tissue) according to the extent of the tumor, assessing bony, soft tissue and spinal canal involvement. A doctor may order a whole body scan utilizing nuclear technology, as well as a CT scan of the lungs and abdomen for staging purposes. To confirm diagnosis, a doctor compares laboratory test results and findings from the aforementioned scans to the patient’s symptoms.

Treatment of Spinal Tumours

Treatment decision-making is often multidisciplinary, incorporating the expertise of spinal surgeons, medical oncologists, radiation oncologists and other medical specialists. The selection of treatments including both surgical and non-surgical is therefore made keeping in mind the various aspects of the patient’s overall health and goals of care.
Non-Surgical Treatments
Nonsurgical treatment options include observation, chemotherapy and radiation therapy. 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 radioresistant (i.e. gastrointestinal tract and kidney): in those cases, surgery may be the only viable treatment option.

Surgery
Indications for surgery vary depending on the type of tumor. Primary (non-metastatic) spinal tumors may be removed through complete en bloc resection for a possible cure. In patients with metastatic tumors, treatment is primarily palliative, with the goal of restoring or preserving neurological function, stabilizing the spine and alleviating pain. Generally, surgery is only considered as an option for patients with metastases when they are expected to live 3 – 4 months or longer, and the tumor is resistant to radiation or chemotherapy. Indications for surgery include intractable pain, spinal-cord compression and the need for stabilization of pathological fractures.
For cases in which surgical resection is possible, preoperative embolization may be used to enable an easier resection. This procedure involves the insertion of a catheter or tube through an artery in the groin. The catheter is guided up through the blood vessels to the site of the tumor, where it delivers a glue-like liquid embolic agent that blocks the vessels that feed the tumor. When the blood vessels that feed the tumor are blocked off, bleeding can often be controlled better during surgery, helping to decrease surgical risks.

If surgery is considered, the approach to the tumor is determined by the tumor’s location within the spinal canal. The posterior (back) approach allows for the identification of the dura and exposure of the nerve roots. This approach is commonly used for tumors in the posterior aspect of the spinal column or to expose tumors inside the dura. Multiple levels can be decompressed, and multilevel segmental fixation can be performed if necessary. The anterior (front) approach is excellent for tumors in the front of the spine. This approach also allows for the reconstruction of defects caused by removal of the vertebral bodies. This approach also allows placement of short-segment fixation devices. Thoracic and lumbar spinal tumors that affect both the anterior and posterior vertebral columns can be a challenge to resect completely. Not infrequently, a posterior (back) approach followed by a separately staged anterior (front) approach has been utilized surgically to treat these complex lesions.

Conclusion

Spinal tumors are abnormal masses of tissue within or around the spinal cord and column, categorized as benign or malignant. While the exact causes remain largely unknown, genetic factors and compromised immune systems can contribute. Symptoms, like non-mechanical back pain, sensory loss, and motor weakness, vary based on tumor type and location. Accurate diagnosis involves thorough medical examination and radiological tests. Treatment decisions encompass surgical and non-surgical options, tailored to individual health and goals. Collaboration between specialists, such as spine surgeons and oncologists, is crucial. Those who are searching for a spinal tumor specialist doctor in Thane look no further at The Spine Clinic led by renowned spine specialist Dr. Priyank Patel, recognized as the best spine surgeon in Thane .