Spinal cord tumors are abnormal cells that grow in the spinal cord, a spinal tumor is a growth that develops within the vertebral canal or within the bones of the spine between its protective sheaths, or on the surface of the sheath that covers the spinal cord. The spinal cord contains bundles of nerve fibers that are well protected inside the vertebra (backbone) which transmit messages from the brain throughout the body and viceversa, a tumor on or near the spinal cord can disrupt communication, impair function, and cause serious health concerns.
Spinal cord tumors are of two types primary and secondary –
Primary spinal cord tumors develop from the spinal cord rather than spreading from other parts of the body. The primary spinal cord tumors are usually non-cancerous, and rarely cancerous and does not spread to other parts of the body. Primary spinal cord tumors can affect people of all ages but are seen commonly in young and middle-aged adults.
The secondary cancerous tumors spread from cancer at another site of the body, most cancerous spinal cord tumors are secondary. The secondary cancerous tumors often start as lung, prostate, or breast cancer.
Doctors divide spinal cord tumors into three major groups by their location within the spine based on their location relative to the protective membranes of the spinal cord.
• Extradural tumors - Extradural tumors grow either in the membrane surrounding the spinal cord (the dura mater) or the nerve roots that reach out from the spinal cord. Most spinal cord tumors are extradural, these kind of tumors may affect spinal cord function by causing spinal cord compression. Extramedullary tumors that affect the spinal cord include meningiomas, neurofibromas, schwannomas, and nerve sheath tumors.
• Intradural-extramedullary - Intradural-extramedullary are tumors that grow outside the spinal cord but within the dura mater, these kinds of tumors develop in the spinal cord's arachnoid space(meningiomas), the nerve roots that reach out from the spinal cord(Schwannomas and neurofibromas), or at the spinal cord base(filum terminale ependymomas).
• Intramedullary tumors - Intramedullary tumors grow inside the spinal cord, it begins in the cells within the spinal cord itself, like gliomas, astrocytomas, or ependymomas.
Tumors from other parts of the body can spread to the vertebrae, the supporting structures around the spinal cord, and in rare cases, the spinal cord itself.
Spinal tumors or growths of any kind can cause pain, neurological problems, and sometimes paralysis. A spinal tumor could also be life-threatening and cause permanent disability .Spinal cord tumors generally grow slowly and over time they can worsen and cause symptoms depending upon their location. Symptoms arise because the tumor presses on the spinal cord or the nerves that exit it. Tumors also may restrict the blood flow to the spinal cord. Common symptoms include:
• Pain - Back pain is typically the most prominent symptom, but pressure on the spinal cord can trigger pain that feels as if it is coming from various parts of the body. This pain is usually severe, is usually constant, and may have an aching or burning quality.
• Sensory changes - These can cause numbness, tingling, decreased sensitivity to temperature, or cold sensations.
• Motor problems - Tumors that hinder nerve communication can cause muscle-related symptoms, like progressive muscle weakness or loss of control over the bowel or bladder.
The symptoms will vary depending on the tumor's location on the spinal cord, generally symptoms occur in parts of the body that are at the same level as or below the tumor. Once it develops, a spinal tumor usually will keep growing until it's treated. Without treatment, it can cause permanent paralysis, significant disability, and death.
If one has any symptoms of spinal cord tumor the doctor makes a physical examination and reviews the past medical record. The physical examination includes standard neurological examination which checks pupil reaction, eye reflexes, eye movements, hearing, sensation, balance and coordination, strength, reflexes, etc. If the doctor suspects a spinal tumor, he or she may recommend x-rays of the spine and other diagnostic tests which may include
• Computerized tomography (CT) Scan. Computerized tomography can determine the location of the tumor on the spinal cord, and helps detect swelling, bleeding and other associated conditions. A dye is usually injected into a vein before the scan which helps show differences between tissues, which makes it easier to visualize the tumor.
• Magnetic resonance imagining (MRI) scan. This technique gives an image of the spinal cord and provides better pictures of tumors near bone than computerized tomography.
• Myelogram. This is a specialized X-ray technique during which a dye that absorbs X-rays is injected into the spinal cord. The dye outlines the spinal cord, but will not pass through the tumor, creating a picture with a dark or narrowed area that indicates the tumor's location. Myelograms are done only occasionally as MRI provides similar information without the necessity of a spinal injection.
• Spinal puncture. This procedure removes a sample of cerebrospinal fluid, which is tested for abnormal cells which can suggest the presence of a spinal cord tumor.
• Biopsy. A sample of the tumor is removed and examined under a microscope to confirm the diagnosis and rule out other conditions, as it is difficult to obtain a biopsy without damaging the spinal cord and it is done with careful planning and imaging with MRI or CT scan.
Treatment for a spinal tumor may include surgery, radiotherapy, chemotherapy, or other medications.
Surgery is usually recommended for noncancerous and cancerous primary spinal cord tumors and is successful for tumors located outside the spinal cord. However, other tumors it is impossible to remove without significantly damaging the spinal cord. In those cases, radiotherapy could also be done to slow the tumor’s growth. Surgical removal of surrounding vertebrae also can help to alleviate pain and other symptoms by reducing pressure on the spinal nerves. Chemotherapy is recommended for certain kinds of tumors, usually after surgical procedures.
For secondary tumors, the treatment will depend on the kind of cancer that has spread to the spinal cord. However, radiation is considered a primary treatment for secondary cancer that's compressing the spinal cord. With radiotherapy, care is taken to limit possible damage to surrounding normal spinal tissue, because such damage can still worsen and may be irreversible. The spinal cord is more sensitive to the consequences of radiation than brain tissue, particularly the thoracic spinal cord segments in the area of the ribs where about half all spinal cord tumors occur are very sensitive to radiation's effects.
With all kinds of spinal cord tumors corticosteroid drugs also are prescribed to reduce spinal cord swelling. Physiotherapy is also needed to assist the individual to regain muscle control and strength after radiation or surgery.
The prognosis will depend on where the tumor on the spinal cord is located, the kind of tumor, and also the size of the tumor at the time of diagnosis. Early diagnosis and treatment are essential to restoring function and preventing permanent damage to the spinal cord.
Back pain or neck pain is a common problem and is rarely a symptom of the spinal tumor, but evaluation by a neurologist is essential if there's persistent pain or pain in the back which is worsening, and if the pain keeps one awake in the night. If one is experiencing numbness, tingling or weakness visit the neurologist at once especially if one has had cancer in the previously.
If one has chronic back or neck pain that hasn't responded to conventional treatments it may be time to seek out a spine surgeon. If one is searching for the best neurosurgeon in Bangalore Dr. Venugopal S is one among the leading neurosurgeons in Bangalore having experience over a decade of treating various brain and spine diseases.
For more information about problems associated with the spine contact Dr. Venugopal S.
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