Cancers and tumors of the spine and spinal cord are relatively rare, and often present without early symptoms Luckily, most back and neck pain complaints are not due to tumor.
What Are The Symptoms of a Tumor?
Often, a tumor itself will NOT be painful. Back pain is usually not the first symptom of a malignant cancer growing somewhere else in your body. Because of this fact, doctors use routine medical tests in order to find certain cancers before they have a chance to spread instead of evaluating every patient with back pain as if they might have a cancer. If a tumor were to compress a spinal nerve or weaken the bones of the spine causing vertebral fracture, pain could certainly be present. However, other generalized symptoms, such as fatigue or weight loss, will likely be present as well in scenarios of cancerous tumors. When associated with neurological symptoms such as loss of bowel and bladder control, further evaluation is clearly warranted. Be aware of other physical symptoms, such as lumps and bumps, moles on the skin, and any other findings that might suggest that you have a tumor somewhere else in your body. Many benign “tumors” of the spine also exist, such as hemangioma, which can cause a similar clinical picture as a neoplasm if the spinal canal is encroached.
Most of us are aware of some of the risk factors that are associated with cancer in the United States. Cigarette smoking, an unhealthy diet, chemical and radiation exposure, a family history of certain cancers such as breast cancer or ovarian cancer, and over-exposure to the sun are common risk factors for certain cancers. These cancers generally occur in different parts of the body and then spread to the spine typically after the cancer has been growing for a long period of time. The spine and vertebral bodies have a rich blood supply and cancer cells can spread to this part of the body by traveling in the bloodstream. Regular mammograms to look for breast cancers, pap smears to look for cervical cancer, chest x-rays to look for lung cancers, and fecal occult blood tests for colon cancers should be part of everyone’s health maintenance program.
Malignant Spine Tumors:
Malignant, or cancerous, tumors that have spread to the spine can lead to a significant amount of pain. If they are large enough, they may put pressure on the spinal cord, which causes increasing pain and loss of normal functioning in the bowel, bladder, and legs. Metastatic cancer may not be curable, but the treatment goals are usually directed at relief from pain, decompression of the neural elements (removing the pressure on the spinal cord and nerves), and preserving the patient’s quality of life as much as possible. Surgery, chemotherapy, and localized radiation therapy all play a role in reducing the pain associated with cancers that have spread to the spine from other sites. Minimally invasive spinal surgery is the preferred modality of treating malignant spinal tumors that require resection. Decrease in operative time, muscle and tissue damage, and infection rates in an already immune compromised cancer patient are fundamental benefits over the more aggressive, traditional “open” spine surgery.
Myeloma is the most common primary malignant tumor of bone. It typically affects adults greater than 40 years of age. It tends to be generalized, involving multiple bones, but pain and involvement of the spine is the most common presenting complaint.203 Surgery may be required if pathological fractures develop or there is compression of the spinal cord.
Osteosarcoma is the second most common primary malignant tumor of bone. There are two age groups that most often develop this type of cancer. It typically affects adolescents and young adults, with a second peak of incidence in older adults. It is very rare in the spine.
Benign Spine Tumors:
The term “benign” indicates that a particular tumor is unlikely to spread to others parts of the body. Benign tumors can still be a significant problem however, depending upon their location, size, adjacent structures, blood supply, and other factors. Fortunately, most benign tumors can be treated successfully with minimally invasive resection. Examples of benign spinal lesions include: Osteoid Osteomas, Osteblastomas, Aneurysmal Bone Cysts, Giant Cell Tumors and Eosinophilic Granuloma
Treatment of a spinal tumor depends on the pathology. Non-operative measures may include radiation or chemotherapy if indicated. However, if a patient is symptomatic from a spinal tumor, or if the tumor warrants further investigation , the following are potential surgical options:
• Minimally Invasive Tumor Biopsy
• Minimally Invasive Spinal Decompression
• Minimally Invasive Tumor Resection
• Minimally Invasive Spinal Exploration