World Spine Day 2023: Types, Symptoms, Causes, Treatment- All You Need To Know About Spinal Tumors

Understanding the symptoms and causes of spinal tumours is crucial for early detection, proper diagnosis, and appropriate treatment.

All about spinal tumours

Spinal tumours, whether they are benign (non-cancerous) or malignant (cancerous), are abnormal growths of tissue within the spinal column or spinal cord. These tumours can cause various symptoms and can significantly affect a person's quality of life. Understanding the symptoms and causes of spinal tumours is crucial for early detection, proper diagnosis, and appropriate treatment.

What Are Spinal Tumours All About? 

Dr. Hitesh Garg, who is the Head - of Ortho Spine Surgery, at Artemis Hospitals, Gurugram said, "Speaking in simple terms, spinal tumours are abnormal growths of cells occurring within or around the spinal cord. The spinal cord is a significant part of the central nervous system that transmits signals between the brain and the rest of the body. These tumours can be benign (non-cancerous) or malignant (cancerous), and they can develop at any level of the spine, including the cervical, thoracic, lumbar, and sacral regions. 

Types Of Spinal Tumors:

Dr. Hitesh Garg mentioned the following:

• Intramedullary Tumors: These tumors originate within the spinal cord itself. Generally, they grow slowly and are typically benign but they can be malignant in some cases.
• Extramedullary Tumors: These tumours are characterized by their development outside the spinal cord but within the spinal column. The most common types are meningiomas, schwannomas, and neurofibromas. Most extramedullary tumours are benign, but some can be cancerous.
• Intradural-Extramedullary Tumors: These tumours are located within the protective coverings of the spinal cord and are mostly benign. Common examples include meningiomas, nerve sheath tumours, and arachnoid cysts. 
• Extradural Tumours: These tumours grow outside the spinal cord and its protective coverings. They are mostly metastatic cancers that can radiate from other parts of the body, like lung, breast, or prostate cancer.

Factors Contributing To The Development Of Spinal Tumours:

The exact causes of spinal tumours are not clear but some factors that may contribute to their development mentioned by Dr. Hitesh Garg are:

• Genetics: Inherited genetic mutations can enhance the chances of developing some types of spinal tumours.
• Radiation Exposure: Exposure to radiation therapy or environmental radiation previously can be a risk factor.
• Immunosuppression: A deteriorated immune system caused by conditions like HIV or immunosuppressive medications is likely to increase vulnerability to certain spinal tumors.

Causes Of Spinal Tumours:

Spinal tumours can arise from various cell types and can be primary or secondary (metastatic). Here are the main causes of spinal tumours listed by Dr. K. Vamshi Krishna, Consultant - Neurosurgeon & Endoscopic Spine Surgeon, CARE Hospitals, Nampally, Hyderabad:

• Primary Spinal Tumours: These tumours originate within the spinal cord, spinal nerves, or the surrounding structures of the spine. They can be benign or malignant, arising from different cell types within the spine.
• Secondary or Metastatic Tumours: Metastatic tumours occur when cancer cells from other parts of the body spread to the spine. Common primary sites include the lungs, breast, prostate, or other organs.
• Meningiomas: Meningiomas are usually slow-growing tumours that originate from the meninges, the protective membranes surrounding the brain and spinal cord.
• Schwannomas: Schwannomas are benign tumours that develop from Schwann cells, which produce the protective myelin sheath around nerves.
• Ependymomas: Ependymomas are tumours that arise from the ependymal cells lining the central canal of the spinal cord.
• Astrocytomas: Astrocytomas are tumours that develop from astrocytes, a type of glial cell in the central nervous system.
• Hemangiomas: Hemangiomas are noncancerous growths of blood vessels within the spine.
• Lipomas: Lipomas are noncancerous fatty tumours. They can develop within the spinal cord or the space around it.
• Lymphomas: Lymphomas are cancers that develop from lymphocytes and can affect the spinal cord or the spinal bones.
• Intradural Extramedullary Tumours: These tumours grow within the protective covering of the spinal cord but outside the spinal cord itself.
• Extradural Tumours: Extradural tumours develop outside the protective covering of the spinal cord, often affecting the bones of the spine or nearby tissues.

Symptoms Of Spinal Tumors:

The symptoms of a spinal tumour can vary depending on the tumour's size, location, rate of growth, and whether it is pressing on the spinal cord, nerves, or surrounding structures. Common symptoms mentioned by Dr. K. Vamshi Krishna include:

• Pain: Persistent or severe back or neck pain, which may worsen at night or with physical activity. Pain radiates to other parts of the body, such as the arms, legs, or chest, based on the tumour's location and its effect on nerves.
• Muscle Weakness or Numbness: Weakness or numbness in the arms, legs, or other areas of the body. This can result from pressure on the spinal cord or nerves.
• Difficulty Walking: Problems with balance, coordination, and walking due to the tumour's impact on the spinal cord.
• Changes in Bowel or Bladder Function: Bowel or bladder incontinence, urgency, or difficulty controlling bowel movements or urination.
• Sensory Changes: Changes in sensation, such as tingling, numbness, or a "pins and needles" sensation in various body parts.
• Muscle Spasms: Uncontrolled muscle spasms or contractions.
• Lack of Coordination: Difficulty coordinating movements, especially in the hands and arms.
• Difficulty Breathing: Breathing difficulties if the tumour affects the nerves that control the diaphragm.
• Scoliosis or Kyphosis: Abnormal curvature of the spine, which can cause deformities like scoliosis or kyphosis.
• General Weakness and Fatigue: Overall fatigue and weakness due to the body's efforts to cope with the presence of the tumour.

Diagnoses Of Spinal Tumours:

Dr. Ashish Gupta, who is a Senior Director of Neurosurgery, at Max Super Speciality Hospital, Patparganj mentioned the following ways of diagnosing spinal tumours:

• Complete Medical History, Physical and Neurological Examination
• Blood Investigations
• MRI Spine with Contrast - MRI scans are the best at viewing tumours.
• CT Scan - Spine
• CT-myelography 
• Spine X-rays
• PET Scan
• Bone Scan

Treatment Options For Spinal Tumours:

Dr. Hitesh Garg suggested the following treatment options:

• Surgery: The primary treatment for many spinal tumours includes taking out as much of the tumour as possible. In some cases, complete removal may not be possible, but surgery can still help in relieving the pressure on the spinal cord and nerves.
• Radiation Therapy: Radiation is used to target and shrink tumours. This is done especially when complete surgical removal is not feasible.
• Chemotherapy: Chemotherapy may be used for certain types of spinal tumours, mainly those that are malignant and have spread from other parts of the body.
• Targeted Therapies: Targeted therapies and immunotherapies, significantly help in managing some types of spinal tumours, especially those that are malignant and have specific genetic signs.
• Managing Symptoms: Managing symptoms and providing supportive care is an important aspect of spinal tumour care. Managing symptoms is necessary to improve the patient's quality of life.

Spinal tumours encompass a diverse group of growths that can occur within the spinal cord, spinal nerves, or surrounding structures. Recognising the symptoms associated with spinal tumours and understanding their various causes is crucial for early detection and appropriate medical intervention. If you experience persistent back or neck pain, neurological symptoms, or any concerning signs mentioned above, seeking prompt medical attention and undergoing necessary diagnostic tests are essential for an accurate diagnosis and timely treatment. The treatment approach for spinal tumours often involves a multidisciplinary approach, including neurosurgeons, oncologists, radiation oncologists, and rehabilitation specialists, to provide comprehensive and tailored care for each case.

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]