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Understanding Spinal Cord Tumours: Types, symptoms, diagnosis and treatment

Dr. Ajay KohliJan 5, 2024

A Spinal Cord Tumour is the growth of an abnormal mass of cells in the region surrounding or within the spinal cord. The spinal cord is a column of nerve tissues that spans from the base of the skull down to the centre of the back.

Three thin layers of protective tissue called membranes form a protective covering over it. In turn, the spinal cord and membranes are enclosed by the vertebrae (backbones). The backbone or spine is a long, flexible bony column that houses the spinal cord. It consists of four regions: cervical, thoracic, lumbar, and sacrum. Although the Spinal Cord Tumour can develop in any of these regions, the thoracic and lumbar regions are the most likely locations. Read ahead for an overview of Spinal Cord Tumour.

Contents

Types of Spinal Cord Tumours
Specific types of Spinal Tumours
Symptoms of Spinal Tumours
Diagnosis of Spinal Tumours
Ways to treat Spinal Cord Tumours
Frequently Asked Questions (FAQs)

Types of Spinal Cord Tumours

Based on their location within the spine, the Spinal Cord Tumours are classified into 3 types.

Intradural-extramedullary: The tumour is located inside the dura, which is the thin covering of the spinal cord. The most common types of these tumours are meningiomas, schwannomas, and neurofibromas.
Intramedullary: These tumours are seated inside the spinal cord. Their origin is found in the glial or ependymal cells which are located along the entire interstitium of the spinal cord. The common types of tumours under this category are astrocytomas and ependymomas.
Extradural: In such types, the tumour is situated outside the dura or covering. These tumours develop because of metastatic cancer. The bony spinal cord is the most common site for bone metastasis to occur. Lung, breast, and prostate cancer are likely to spread to the spine.

Specific types of Spinal Tumours

There are several types of spinal tumours, comprising different cells and tissues. Some of these are mentioned below.

Meningiomas: These are tumours of the meninges that cover the brain and spinal cord. They are usually benign in nature.
Schwannomas: If a tumour develops in the cells surrounding the nerve fibres of the peripheral nervous system, spinal cord, and cranial nerves, it is called schwannomas. Again, these are mostly benign.
Neurofibromas: These are benign tumours which grow on nerves in your body, including the spinal cord. They occur in relation to a genetic disorder.
Astrocytomas: When tumours develop inside the supporting cells of the spinal cord, it is called astrocytomas. Some of these may be benign in nature while others are malignant.
Ependymomas: Tumours that form in the linings of the spinal fluid passageways to the brain and spinal cord, are called ependymomas.

Symptoms of Spinal Tumours

Non-mechanical back pain is an early symptom of both benign and malignant spinal tumours. Such pain is generated by the spine, intervertebral discs, and the surrounding soft tissues. Other frequently seen signs and symptoms may include the following.

Back pain that often spreads to other parts of the body
Loss of bowel or bladder function
Difficulty walking and maintaining balance
Pain at the site of the tumour due to tumour growth
Feeling less sensitive to change in temperature
Back pain that gets worsened while lying down
Muscle weakness or loss of sensation in the arms and legs
Loss of bowel or bladder function

Diagnosis of Spinal Tumours

For diagnosing the presence of Spinal Cord Tumours, one or more of these diagnostic evaluations come in handy.

Radiological imaging studies: Helps to identify the appearance and location of the tumour.
MRI Scan: It brings out the exact location, structure, and size of the tumour in relation to the spinal cord.
CT Scan: Gives a better and clearer visual picture of the structure of the bones.
Spine X-Ray: This helps in detecting the location of metastatic spinal tumours which develop in the bony part of the spinal column.
Cerebrospinal fluid analysis: This analysis is done to find tumour cells.
Blood tests: It can reveal the presence of calcium and alkaline phosphatase. Abnormal levels of these indicate that bone tissue has broken down which can happen due to cancer.
Biopsy: A sample taken from the tumour helps to identify the exact classification of the tumour.
Bone scan: A small amount of radioactive substance is introduced into the body through a vein. The radioactive material is then tracked using imaging techniques to help detect abnormal areas in the spinal cord.

Ways to treat Spinal Cord Tumours

Treatment of Spinal Cord Tumours is very specific and depends on various factors like location, size, and type of tumour. For treating a benign tumour, an MRI may be recommended to monitor the progress of the tumour. Primary spinal tumours that are asymptomatic or mildly symptomatic may be completely removed surgically. However, if it is an intramedullary Spinal Cord Tumour, which is deep-seated, surgical removal is not an option as it may lead to neural damage.

For malignant, metastatic tumours, a different approach is needed. A combination of one or more of the following procedures is useful for treating malignant tumours.

Radiation Therapy: High doses of X-rays are used to destroy or shrink the tumour cells. Even if we shrink the tumour, its presence is brought to such an extent that the pain and other associated symptoms are reduced or almost negligible.
Chemotherapy: Drugs are introduced into the body by injecting into a vein or given orally. These chemotherapy drugs destroy cancer cells in the spine and throughout the body. Sometimes, chemotherapy is done before a surgery to reduce the size of the tumour.
Stereotactic radiosurgery: A safe, non-surgical and non-invasive method to allow radiation beams to fall only on the tumour, leaving the nearby tissues unharmed.
Surgery: This is an option in cases where radiation therapy and chemotherapy fail to do their work. Surgery can bring pain relief while keeping the neurologic functions intact and making the spine stable. The surgery could be a traditional, open one or minimally invasive procedure. Vertebroplasty or kyphoplasty may be done which means injecting bone cement into the spine after removal of the tumour.

Frequently Asked Questions (FAQs)

Here’s a list of common questions and answers related to Spinal Cord Tumours.

What are the risk factors for developing spine tumours?

The exact reason for the cause of developing spine tumours is not yet known. People who suffer from immune disorders or genetic conditions such as neurofibromatosis type 2 are more likely to develop spine tumours.

What types of cancers spread (metastasize) to the spine?

The following types of cancers can metastasize to the spine, causing tumours.

Lung cancer
Breast cancer
Prostate cancer
Leukaemia
Lymphoma
Multiple myeloma
Melanoma
Sarcoma
Kidney cancer
Thyroid cancer
Cancer of the gastrointestinal tract

Who is likely to be affected by Spinal Tumours?

Anyone can be affected by Spinal Tumours, but people who already suffer from cancers of the lung, breast, and prostate are more likely to develop Spinal Cord Tumours. Such tumours are called secondary or metastatic spinal tumours. Primary tumours are rare in occurrence and more likely to be seen in adults in the age group of 65 and 74. Children between ages 10 to 16 are susceptible to it.

Are Primary Spinal Tumours preventable?

No, Primary Spinal Tumours are not preventable. Primary tumours can occur as a result of having certain genetic conditions such as Neurofibromatosis Type 2 and Von Hippel-Lindau disease. If you have a first-degree relative (parent or sibling) who has one of these conditions, you are more likely to develop spinal tumours as a result of either of these two genetic conditions.

How can I prevent secondary (metastatic) spinal tumours?

Not all secondary (metastatic) spinal tumours are preventable. The best possible way of preventing these is with adjuvant or neoadjuvant therapies, in case you have been diagnosed with a localised cancer. Adjuvant therapy works by shrinking the size of the primary tumour so that tumour cells can be prevented from breaking away and metastasizing.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.