Spinal cord tumors develop from the spinal cord itself or from its surrounding membranes and nerve roots. They may present with slowly progressive numbness, weakness and imbalance; treatment is usually microsurgery.
What is a spinal cord tumor?
Spinal cord tumors lie within the spinal canal and are classified by their location:
- Intradural extramedullary tumors: Located inside the membrane surrounding the spinal cord but outside the cord itself. Meningioma and schwannoma (nerve sheath tumor) are the most common and are usually benign.
- Intramedullary tumors: Arise from within the spinal cord tissue. Ependymoma and astrocytoma are the main examples.
Various tumors can also occur in the cauda equina and conus medullaris, where the spinal cord ends in the lower back.
Symptoms
- Back or neck pain; pain radiating along a nerve root
- Slowly progressive numbness and weakness in the arms or legs
- Gait and balance problems
- Impaired bladder and bowel control, sexual dysfunction
Diagnosis
Contrast-enhanced spinal MRI is the key investigation, showing the tumor's location, size and relationship to the spinal cord. The definitive diagnosis is made by pathological examination of the surgically removed tissue.
Treatment Approach
- Microsurgery: The main treatment for most spinal cord tumors. The operation is performed under a microscope, and nerve function is monitored throughout with intraoperative neuromonitoring. Most benign extramedullary tumors can be removed completely.
- Radiotherapy and radiosurgery: May be used as additional treatment for tumors that cannot be fully removed, that recur, or that are malignant.
- Observation: Some small, benign tumors that cause no symptoms can be monitored with MRI.