A spinal cord tumor is a rare but clinically significant disorder of the central nervous system in which a tumor forms in or on the spinal cord. Such tumors can be benign or malignant and may compress the spinal cord as they grow. Depending on their location within the spinal cord, they can cause neurological symptoms such as paralysis, sensory disturbances, or back pain.
Spinal cord tumors can occur either primarily as primary tumors or secondarily as metastases from other tumors. The proximity to the spine and to sensitive nerve structures makes this condition particularly challenging from a medical standpoint. Early diagnosis is crucial for prognosis and treatment.
Definition: Spinal Cord Tumors
Spinal cord tumors are located within the nerve cells and cause changes there. A distinction is made between
- tumors that originate in the spinal cord and
- tumors that press on the spinal cord from the outside.
Spinal cord tumors account for 2 to 4 percent of all tumors of the nervous system. The incidence is 1 per 100,000 people. Ninety-five percent of these rare tumors are benign. This means they do not spread throughout the body and are therefore not life-threatening.
What types of spinal cord tumors are there?
A distinction is made between spinal cord tumors that originate from the nerve cells of the spinal cord and those that originate from the blood vessels within the spinal cord.
The most common spinal cord tumors are called ependymomas. These tumors originate from the cells lining the central canal of the spinal cord and displace the nerve cells. Only very few of these tumors become malignant and spread to other parts of the body.
The most common vascular tumors are cavernomas. They can occur anywhere in the spinal cord and become symptomatic due to acute hemorrhages.
What symptoms does a spinal cord tumor cause?
Vascular tumors cause acute back pain that occurs suddenly. They are very often accompanied by neurological deficits, such as sensory disturbances or paralysis.
Tumors of the nerve cells grow slowly and, over time, cause increasing symptoms, such as
- back pain,
- paralysis, and
- sensory disturbances.
There is no single typical symptom, so many spinal cord tumors are not detected until later.
Diagnosis of a Spinal Cord Tumor
Among other things, magnetic resonance imaging (MRI) should provide information about the nature of the mass and its extent within the spinal cord.
It is important that the doctor has ruled out the following conditions as causes of the symptoms:
- inflammation of the intervertebral disc and the spinal canal,
- a bacterial infection,
- rheumatic diseases,
- overuse and osteoarthritis in the sacral region,
- hip joint degeneration,
- heart disease (e.g., coronary heart disease),
- peripheral arterial disease (PAD),
- abdominal aortic aneurysm,
- mechanical changes in nerves, and
- muscular disorders.
Conditions such as an abdominal aortic aneurysm can cause symptoms similar to those of a spinal cord tumor © bilderzwerg | AdobeStock
What treatment options are available for spinal cord tumors?
Conservative therapy is the first-line treatment for a spinal cord tumor. Essentially, this involves pain management with medication. Prompt diagnosis is helpful in this case.
Other measures provide little relief. As soon as a spinal cord tumor causes symptoms and has been diagnosed, surgical removal should be considered.
Surgical treatment is primarily used for a spinal cord tumor when paralysis and/or sensory disturbances have occurred. The symptoms are often very severe and lead to partial or complete paralysis of the patient.
The surgical technique depends on the extent and location of the spinal cord tumor. In most cases, the tumor is removed from the back, with stabilization of the spine.
The procedure is performed under general anesthesia; the spine is opened, the spinal cord is exposed, and the surgery is performed while monitoring nerve conduction.
If surgical removal is not possible, radiation therapy is used.
What follow-up care is required after surgery for a spinal cord tumor?
After surgery to relieve pressure on the spinal cord, early mobilization is recommended. Physical therapy is helpful in this regard. Regular follow-up examinations and imaging should be scheduled going forward.
FAQs on Spinal Cord Tumors
What is a spinal cord tumor?
A spinal cord tumor is a growth of tissue in or near the spinal cord. These tumors can be benign or malignant and may grow inside or outside the spinal cord. Depending on their location, they cause different symptoms.
What symptoms does a spinal cord tumor cause?
Typical symptoms of a spinal cord tumor include back pain, neurological deficits, paralysis, or sensory disturbances in the arms or legs. Bladder or bowel dysfunction may also occur. These symptoms are usually caused by pressure on the spinal cord or the nerve roots.
How is a spinal cord tumor diagnosed?
A spinal cord tumor is diagnosed through a neurological examination and imaging techniques such as MRI or CT. Contrast dye is often used to better assess the tumor’s location and extent. An accurate diagnosis of the spinal cord tumor is crucial for treatment planning.
What types of spinal cord tumors are there?
There are intramedullary tumors, such as ependymomas and astrocytomas, which grow within the spinal cord, as well as tumors outside the spinal cord, such as meningiomas. Metastases from other cancers are also among the common types of spinal cord tumors. The type of tumor influences the prognosis.
How is a spinal cord tumor treated?
Spinal cord tumors are often treated surgically using microsurgery. The goal is to remove as much of the tumor as possible while sparing the surrounding tissue. Radiation therapy or chemotherapy may be used as adjunctive treatments, depending on the type, location, and malignancy of the tumor.
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