Spinal Cord Tumor

DEFINITION

A spinal tumor is a growth that develops within your spinal canal or within the bones of your spine. It may be cancerous or noncancerous.

Tumors that affect the bones of the spine (vertebrae) are known as vertebral tumors.

Tumors that begin within the spinal cord itself are called spinal cord tumors. There are two main types of tumors that may affect the spinal cord:

• Intramedullary tumors begin in the cells within the spinal cord itself, such as astrocytomas or ependymomas.
• Extramedullary tumors develop within the supporting network of cells around the spinal cord. Although they don’t begin within the spinal cord itself, these types of tumors may affect spinal cord function by causing spinal cord compression and other problems. Examples of extramedullary tumors that can affect the spinal cord include schwannomas, meningiomas and neurofibromas.

Tumors from other parts of the body can spread (metastasize) to the vertebrae, the supporting network around the spinal cord or, in rare cases, the spinal cord itself.

Spinal tumors or growths of any kind can lead to pain, neurological problems and sometimes paralysis. Whether cancerous or not, a spinal tumor can be life-threatening and cause permanent disability.

Treatment for a spinal tumor may include surgery, radiation therapy, chemotherapy or other medications.

CAUSES

It’s not clear why most spinal tumors develop. Experts suspect that defective genes play a role. But it’s usually not known whether such genetic defects are inherited, occur spontaneously or are caused by something in the environment, such as exposure to certain chemicals. In some cases, however, spinal cord tumors are linked to known inherited syndromes, such as neurofibromatosis 2 and von Hippel-Lindau disease.

Types of spinal cord tumors

Spinal cord tumors are classified according to their location in the spine.

Your spinal cord is a long column of nerve fibers that carries messages to and from your brain. Wrapped around the entire spinal cord are three protective membranes known as meninges. The tough outer later is the dura mater, the middle layer is the arachnoid membrane and the innermost later is the pia mater.

Spinal cord tumors may be classified as intradural or extradural depending on where they occur relative to these protective membranes of the spinal cord.

Intradural tumors occur within the dura mater and are further divided into two subcategories:

• Extramedullary tumors. These tumors develop outside the spinal cord, such as in the surrounding dura mater (meningiomas) or in the nerve roots that extend out from the spinal cord (schwannomas and neurofibromas). These tumors are noncancerous in most cases.
• Intramedullary tumors. These tumors begin in the supporting cells within the spinal cord. Most are either astrocytomas or ependymomas. In rare cases, intramedullary tumors from other parts of the body can spread through the bloodstream to the spinal cord itself.

SYMPTOMS

Depending on the location and type of spinal tumor, different signs and symptoms can develop, especially as a tumor grows and affects your spinal cord, surrounding nerves or blood vessels. Signs and symptoms of tumors affecting the spinal cord may include:

• Back pain, sometimes radiating to other parts of your body
• Loss of sensation, especially in your arms or legs
• Difficulty walking, sometimes leading to falls
• Decreased sensitivity to pain, heat and cold
• Loss of bowel or bladder function
• Muscle weakness that may occur in varying degrees and in different parts of your body, depending on which nerves or part of the spinal cord is compressed

Back pain is a common early symptom of both noncancerous and cancerous spinal tumors. Pain may also spread beyond your back to your hips, legs, feet or arms and may become more severe over time in spite of treatment.

Spinal tumors progress at different rates. In general, cancerous spinal tumors grow more quickly, and noncancerous spinal tumors tend to develop very slowly.

When to see a doctor

There are many causes of back pain, and most back pain isn’t caused by a spinal tumor. But because early diagnosis and treatment are important for spinal tumors, see your doctor about your back pain if:

• It’s persistent and progressive
• It’s not activity related
• It gets worse at night
• You have a history of cancer and develop new back pain

Seek immediate medical attention if you experience:

• Progressive muscle weakness or numbness in your legs or arms
• Changes in bowel or bladder function