Spinal tumors

Spinal tumors are categorized by the area and part of the spinal structure where they are located, whether the neck, mid-back or low back. Tumors are classified as one of the following types:

• Extradural are found outside the tissue membrane (dura) that envelopes the spinal cord
• Intradural-extramedullary are located inside the dura but outside the spinal cord itself
• Intramedullary are found inside the spinal cord

• Back or neck pain that worsens over time and is pronounced during physical activity and when lying down
• Bladder or bowel incontinence
• Loss of sensation in the arms and legs
• Muscle spasms
• Pain, numbness, muscle weakness or loss of feeling in the legs

• There is no known prevention method for most spinal tumors.

• Exposure to chemicals or substances known to cause cancer
• Family history of spinal tumors
• The genetic disorders neurofibromatosis types 1 and 2 and Von Hippel-Lindau disease

• Medical history and physical examination. The patient and physician will discuss overall health and medical history, any history of genetic conditions associated with spinal tumors, and symptoms. During the physical examination, the physician will look for signs of nervous system involvement, such as poor reflexes.
• Imaging tests. Imaging studies to assist with making a diagnosis may include X-ray, CT, MRI, positron emission tomography or a bone scan.
• Biopsy. A needle biopsy retrieves a sample of the tumor for testing, which can refine the diagnosis by revealing the tumor type. It can also inform treatment.

• Watchful waiting. If patients have mild symptoms or none at all and the tumor is not growing, the physician may recommend no active treatment and monitor the tumor with imaging studies moving forward.
• Chemotherapy and/or radiation therapy. If a tumor is cancerous, patients may receive one or both of these treatments, depending on the type of tumor.
• Surgery. Surgery may be necessary if other treatments have not worked, the tumor has destabilized the spine, or if patients experience significant symptoms or loss of function, such as bowel or bladder control. The surgeon will remove all or a portion of the tumor and stabilize the spine, as necessary.

• Patients who have surgery may need physical therapy in the hospital or an inpatient rehabilitation facility followed by outpatient physical therapy at home or an outpatient center.
• During recovery, patients should follow physician recommendations regarding pain management and activities to avoid. It may take a few months before patients can resume all normal activities.
• Keep all follow-up appointments with the physician, who will use MRI to look for signs the tumor has returned.