Spinal tumors arise from the bony vertebrae or result from cancer elsewhere in the body spreading to the spine. The most common symptom is back pain that does not settle with rest and worsens at night.
What is a spinal tumor?
Spinal tumors are growths that develop in the bony tissue of the vertebrae. They fall into two main groups:
- Metastatic (secondary) tumors: Formed when cancers of organs such as the lung, breast, prostate or kidney spread to the spine. They are the most common spinal tumors in adults. Blood cancers such as multiple myeloma also frequently involve the spine.
- Primary tumors: Arise directly from the spine. In addition to benign types such as haemangioma, there are rarer malignant types such as chordoma and chondrosarcoma.
Spinal tumors can weaken bone and cause fractures, or press on the spinal cord or nerve roots and cause neurological deficits.
Symptoms
- Back pain that does not settle with rest and worsens at night
- Pain and numbness spreading into the arms or legs
- Weakness in the arms or legs, difficulty walking
- Impaired bladder or bowel control
- A vertebral fracture after minor strain
Diagnosis
MRI best shows the extent of the tumor and its relationship to the spinal cord. CT shows how much the bone is affected, and PET-CT and whole-body imaging show whether there is disease elsewhere. The definitive diagnosis is usually made by biopsy.
Treatment Approach
Treatment is planned by a multidisciplinary team according to the tumor type and extent, the stability of the spine, the neurological status and the patient's general condition:
- Surgery: Removal of tumor compressing the spinal cord (decompression) and, if necessary, stabilisation of the spine with screw-and-rod systems.
- Radiotherapy and stereotactic radiosurgery: Used for pain control and tumor control; CyberKnife can deliver high-precision treatment to spinal lesions.
- Vertebroplasty / kyphoplasty: Strengthening of a collapsed vertebra with bone cement in tumor-related compression fractures.
- Systemic treatments: Chemotherapy, hormone therapy, targeted therapies and bone-strengthening drugs are planned by oncology.