What are Spine Tumors?
A spine tumor is a growth of cells (a mass) within the bones of the spine (vertebrae) or around the spinal cord (the column of nerves that control the limbs). Tumors are either benign or malignant. Benign spine tumors do not spread from their original location but may be “locally aggressive.” Malignant tumors are cancers that can spread their cancer cells to other parts of the body. Whether the tumor spreads or not, a spine tumor can threaten life and cause permanent disability. Most malignant tumors of the spine are a result of spread from another site (such as breast, prostate, lung, thyroid, kidney or gastrointestinal tract).
What are the Symptoms of Spine Tumors?
Symptoms of spine tumors typically include pain or weakness. The vast majority of patients complain of constant “aching” or “gnawing” pain around the tumor, mechanical pain around the tumor aggravated by movement, or radiating “shooting” nerve pain (down the arms, legs or around the chest and belly) related to nerves that are irritated or compressed by the tumor. Patients may also feel night time pain preventing them from sleeping and or experience night sweats and chills. Some patients may experience weakness in the arms or legs due to compression of nerves or spinal cord. In some cases, the compression may lead to problems with urine function, sexual function, or bowel function. Some patients may have a tumor diagnosed by a test and could experience no symptoms at all.
How is a Spinal Tumor Diagnosed?
The first step in the evaluation of a spinal tumor is to get a detailed history. The doctor will perform a physical examination. This may include checking for swelling, tenderness and other possible sites of involvement as well as evaluating motion, alignment and strength of arms and legs. A neurologic examination may also be done. This may include tests of sensory (temperature, pain and pressure sensitivity), motor (muscle strength) and reflex functions of the nervous system. In addition, X-rays may be necessary to look for tumors or dislocations. Other tests such as Bone Scans can identify tumors months before X-rays. Often computed tomography (CT) or magnetic resonance imaging (MRI) scans may be ordered to determine the extent of disease.
What are the Treatment Options for Spine Tumors?
Treatment options for spinal tumors depend on the type of tumor and the extent of the disease. Benign tumors that cause no symptoms may be treated with close observation. Tumors that arise from other sites (metastatic) may be treated with chemotherapy or radiation treatment. Most tumors that are causing severe pain, spinal curvatures, or compression of nerves or spinal cord are treated with surgery.
What are the Surgical Options for Spine Tumors?
The goals of surgical treatment for spinal tumors are to reduce pain, to maintain strength, prevent paralysis, improve function, and to avoid progression of curvatures. This can be accomplished through a variety of surgical techniques with a philosophy of providing the most appropriate and least invasive method of addressing the symptoms of the tumor. If there is compression of the spinal cord or nerves then a decompression procedure followed by a stabilization procedure may be the most appropriate. If there are simply weak bones that are collapsing then a percutaneous vertebral augmentation (injecting cement into the bone using a needle and balloon device) followed by radiation or chemotherapy may be the most appropriate treatment option.
What Can I Expect after Surgery?
Depending on how extensive the tumor is and what form of treatment is prescribed surgery for a spinal tumor is expected to improve pain and function and preserve or increase strength in the arms or legs. Life expectancy after spine tumor surgery is difficult to predict and is related primarily to the underlying disease (type and extent of tumor) rather than to the surgery itself. Newer minimally invasive techniques of spinal surgery through smaller incisions and the use of robotics have made the surgery and recovery easier for our patients. The surgical team at Texas Back Institute work closely with the oncology team to coordinate care and ensure the best possible outcome.