Benign spinal tumor
General information
Spinal cord tumors are formed due to uncontrolled growth of cellular elements caused by a failure in the system of restraining and stabilizing mechanisms. Spinal cord tumors account for 20% of all central nervous system tumors.
Classification
Spinal cord tumors are classified by features in the following order:
- part of the spinal column, where they are located (cervical, thoracic, lumbar, sacral);
- from which spinal cord sheaths they originate;
- benign or malignant nature of the tumor;
- primary tumor or secondary tumor (spread of metastases).
The main types of spinal tumors:
- Extramedullary tumor. Grows in the sheath surrounding the spinal cord or from nerve roots branching off the spinal cord. The most common of these tumor types is meningioma, which develops from the spider sheath, schwannoma, and neurofibroma, which grows in the nerve roots.
Although extramedullary neoplasms do not grow in the spinal cord itself, they do alter its functional activity by putting pressure on it as they grow.
It is worth noting that extramedullary tumors are usually benign. However, neurofibromas can malignize over time.
- Intramedullary tumor. Grows inside the spinal cord. It usually originates from glial or ependymal cells. Astrocytomas and ependymomas are the most common types. More often, they have a benign character.
Extradural tumors grow outside the dura mater and are usually associated with metastatic spread. Occasionally, an extradural tumor may spread through the intervertebral foramen, located partly inside and partly outside the spinal canal. Spinal tumors increase in size at different rates depending on the type.
Causes
Currently, the cause of neoplasms remains unclear. It is assumed that a particular place is occupied by genetic defects, which can be inherited and arise under the influence of unfavorable environmental factors.
It should be noted that two hereditary syndromes reliably determine the development of some spinal cord tumors and are risk factors. These include neurofibromatosis type 2 and Hippel-Lindau disease.
Neurofibromatosis type 2 is characterized by the development of a tumor of the nerves of the hearing organ and progressive hearing loss, as well as a tumor of the spinal canal. In Hippel-Lindau disease, multiple tumors form in the blood vessels of the brain, retina, spinal cord, kidneys, and adrenal glands.
Symptoms of a spinal cord tumor
Symptoms and signs vary as the tumor grows. As the tumor spreads, it affects the spinal cord, nerve roots, blood vessels, and bones.
Symptoms may include the following:
- pain is localized at the site of tumor growth and is not associated with physical activity or other diseases. It may occur at rest, lying down, or while sleeping;
- back pain spreading to the arms and legs;
- decreased sensitivity to heat, cold, and pain;
- disorder of the pelvic organs (disorders of urination, defecation);
- difficulty walking, loss of balance;
- muscle weakness;
- scoliosis and other deformities as a result of the destructive effect of the tumor.
Spinal cord tumors may compress the spinal nerves. Against this background, it is possible to develop partial or complete loss of mobility and changes in sensitivity below the localization of compression. Damage to nerve fibers may be irreversible.
Diagnosis of a spinal cord tumor
A thorough examination is necessary to make an accurate diagnosis when a tumor is suspected.
The attending physician familiarizes himself with the medical history, conducts an interview, identifies characteristic complaints, and performs an examination and neurological examination.
The following instrumental tests are performed when a spinal tumor is suspected:
- Magnetic resonance imaging (MRI) is the preferred method for diagnosing neoplasms of the spinal cord and surrounding tissues. It is based on accurate visualization due to the creation of a magnetic field and radio waves. Contrast agents can be injected for a detailed study of a particular area and structures.
- Biopsy. A biopsy is performed to determine the exact type of tumor. It involves a histological examination of a tissue sample under a microscope. The result will determine the treatment tactics.
- Computed tomography and radiography are less reliable than MRI, but they can be used to diagnose other organs if metastasis is suspected.
After receiving the examination results, the tumor is classified according to its size and degree of penetration into nearby tissues. To confirm or exclude metastasis, a scan of the whole body, targeting the lungs and abdomen, is necessary.
Treatment of spinal cord tumors
The treatment plan is a multidisciplinary task involving neurosurgeons, neurologists, radiologists, oncologists, and other medical specialists. The treatment method choice is based on various aspects, including the patient’s condition and concomitant pathology.
The ideal is complete removal of the tumor, but this goal may not be achievable due to the high risk of complications and damage to the spinal cord and surrounding tissues.
- Monitoring. Sometimes, a tumor may be detected before symptoms develop during an examination for another disease. In this case, the doctor may recommend regular follow-up to monitor growth and spread.
- Surgical treatment. It is the treatment of choice for tumors that can be removed with a low risk of complications. Modern equipment makes it possible to perform surgery and remove hard-to-reach tumors with minimal damage to surrounding tissues.
Combination treatment is considered when the tumor cannot be obliterated. Surgery is then followed by radiation therapy or chemotherapy.
All these treatment options are available in more than 870 hospitals worldwide (https://doctor.global/results/diseases/benign-spinal-tumor). For example, Surgical spine procedures can be done in 31 clinics across Turkey for an approximate price of $11.3 K (https://doctor.global/results/asia/turkey/all-cities/all-specializations/procedures/surgical-spine-procedures).
Prognosis
The outcome depends mainly on the patient’s age, general condition, and the nature of the tumor (benign or malignant, primary or metastatic). The goal of treatment of a primary tumor is its complete removal, leading to a potential cure. In the case of metastatic tumors, the goal is almost always palliative care, which is to improve the quality of life and potentially increase life expectancy.
