Spine tumor is the abnormal growths of uncontrolled tissues or cells in and around the spinal cord. Tumors can either be cancerous (malignant) or non-cancerous (benign). Some of the commonly occurring benign spinal tumors are osteoma, osteoblastoma, hemangioma, and osteochondroma. Most commonly occurring malignant spinal tumors are chondrosarcoma, Ewing’s sarcoma, lymphoma, osteosarcoma, and multiple myeloma. Tumors that begin in the spine are called as primary spinal tumors. Tumors that spread to the spine from other parts such as the breast, prostate, lung, and other areas are called secondary spinal tumors.
The cause of primary spinal tumors is not known, but may occur with genetic defects.
Secondary spinal tumors occur when the cancer cells arise from kidneys, lungs, breasts, and spreads to the spine. Other causes include
- Rapid division of cancer cells in the nerves, bones, or cartilage of the spine
- Exposure to radiations and chemicals
- Hereditary – Neurofibromatosis is a tumor of the spinal nerves
Signs and symptoms
People with spine tumor observe persistent and chronic back pain, numbness, burning and tingling sensation, loss of sensation in legs, arms, ankle, knee, and difficulty in balancing, and also experience bladder or bowel control problems.
Spine cancer can be diagnosed by neurological examination which identifies the exact location of the tumor. Other imaging tests done to confirm the spinal tumor may include cerebrospinal fluid (CSF) examination, myelogram, and spine computed tomography scan, spine magnetic resonance imaging scan, and spine X-ray.
In addition to these tests, bone scan and positron emission tomography (PET) scan are also done. After the tumor is found, biopsy is done to identify the type of tumor and provide necessary treatment.
Medications such as corticosteroids and anti-inflammatory drugs are prescribed to reduce inflammation and swelling around the spinal cord. External braces are also used which provide support and control pain.
Other treatments include chemotherapy, radiation therapy, surgery, and physical therapy which may provide permanent relief.
- Surgery: It is done to remove the tumor confined only to one portion of the spine. To minimize nerve damage, electrodes are used to test different nerves of the spine. In some cases sound waves are used to break tumors and the remaining tissues are removed.
- Radiation therapy: This method uses high beam of radiations to destroy the cancer cells. It is used after surgery to destroy the remaining cancer cells. An advanced device called cyberknife, painless and non-invasive treatment that passes high doses of radiations to the targeted areas of the spinal cord is used in radiotherapy.
- Chemotherapy: Combination of anti-cancer drugs is used to destroy the cancer cells. Chemotherapy is used to shrink the cancer cells, to stop the division of cancer cells, and prevent them from spreading to surrounding tissues. The drugs enter the bloodstream and reach the cancer cells to destroy them. Some of the commonly used drugs are methotrexate, doxorubicin, cyclophosphamide, carboplatin, and ifosfamide.
Some of the complications observed after surgery are temporary loss of sensation, nerve tissue damage, and bleeding
Physical therapy: Exercises may be needed to improve muscle strength and the ability to function independently.
Infections involving the spinal canal are rare and include osteomyelitis, discitis, and epidural abscesses. Osteomyelitis refers to an infection of the vertebral bone of the spinal column caused by a bacteria or fungus. Discitis is an infection of disc between two vertebrae, occurs more commonly in children. Epidural abscess is a collection of pus between the dura, a membrane that covers the spinal cord and nerve root.
Osteomyelitis patients may experience fever and chills, severe back pain, weight loss, painful urination, and intolerance to light. Neurological symptoms may also be present if the disease progresses. Discitis patients develop severe back pain, and children may refuse to flex the spine. Patients with epidural abscess may develop a pins and needles sensation or mild weakness.
Spinal infections are caused by either a bacterial or fungal infection that is carried into the spine through blood stream. Certain risk factors for spinal infections include age, smoking, poor nutrition, obesity, drug addiction, compromised immune system, diabetes, and cancer.
Your doctor will diagnose spinal infections with physical examination and history. Additional tests may be ordered to look for an infection and may include plain X-rays, CT scan or MRI scan. Magnetic resonance imaging scan is the most reliable test to determine the presence and extent of infection and presence of spinal compression.
Blood cultures may be ordered to determine type of bacteria or fungus causing the infection. Additional blood tests such as a white blood cell (WBC) count, C - reactive protein (CRP) and an erythrocyte sedimentation rate (ESR) may be performed to screen for signs of an infection.
Treatment depends on the severity of the infection and the organism causing the infection.
Long-term intravenous antibiotic or antifungal therapy may be recommended. Bracing may be recommended to provide stability for the spine until healing occurs and help with pain.
Surgery may be necessary if the infection does not respond to antibiotic therapy. Surgery involves removal of infected tissue with stabilization of spine. Surgical technique is used to join together two bones in the spine. In some cases, metal implants such as rods, hooks, wires, plates or screws are used to hold the vertebra firm until new bone grows between them.