Spinal Cord Tumors

Symptoms of Spinal Cord Tumor

Spinal cord tumors can cause different signs and symptoms, especially as the tumors grow. Tumors can affect your spinal cord or the nerve roots, blood vessels, or bones of your spine. Signs and symptoms may include:

• Pain at the tumor site due to tumor growth
  Back pain that often spreads to other parts of your body
  feeling less sensitive to pain, heat, and cold
  Loss of bowel or bladder function
  Difficulty walking, sometimes causing falls
  back pain that is worse at night
  Loss of sensation or muscle weakness, especially in your arms or legs
  muscle weakness, which can be mild or severe in different parts of your body
  Back pain is a common early symptom of spinal tumors. The pain may also radiate beyond your back to your hips, legs, feet or arms and may worsen over time, even with treatment.
  Spinal tumors progress at different rates depending on the type of tumor.

When to See a Doctor

Back pain has many causes, and most back pain is not caused by a tumor. However, early diagnosis and treatment are important in spinal tumors.

• It is permanent and progressive.
  Activity related changes.
  It gets worse at night.
  It may be accompanied by nausea, vomiting or dizziness.

The following situations are urgent:

• Progressive muscle weakness and numbness in the legs and feet
  Changes in bowel or bladder function

Causes of Spinal Cord Tumor

It is not clear why most spinal tumors develop. Pathological genes are suspected to play a role. However, it is often unknown whether such genetic disorders are inherited or develop over time. They can be caused by something in the environment, such as exposure to certain chemicals. However, in some cases it is associated with known inherited syndromes such as spinal cord tumors, neurofibromatosis 2 and von Hippel-Lindau disease.

Risk Factors for Spinal Cord Tumors

Spinal cord tumors are more common in people who have:

• Neurofibromatosis 2: In this inherited disease, benign tumors develop on or near the nerves involved in hearing. This can lead to progressive hearing loss in one or both ears. Some people with neurofibromatosis 2 also develop tumors of the spinal canal.
  Von Hippel-Lindau disease: This rare, multiple system disorder is associated with blood vessel tumors (hemangioblastomas) in the brain, retina, and spinal cord, and other types of tumors in the kidneys or adrenal glands.

Complications

Spinal cord tumors can compress the spinal nerves, leading to loss of movement or sensation below the tumor site. This can sometimes cause changes in bowel and bladder function. Nerve damage can be permanent. However, if diagnosed and treated early, it may be possible to prevent further loss of function and restore nerve function. Depending on its location, a tumor pressing on the spinal cord can be life-threatening.

Diagnosis

Spinal tumors are sometimes overlooked because they are not common and their symptoms are similar to the more common conditions. Therefore, it is particularly important that your doctor knows your full medical history and performs both physical and neurological exams.

• Spinal magnetic resonance imaging (MRI): MRI uses a strong magnetic field and radio waves to produce accurate images of your spine, spinal cord, and nerves. MRI is often the test of choice for diagnosing tumors of the spinal cord and surrounding tissues. During the test, a contrast agent may be injected into a vein in your hand or forearm to help highlight certain tissues and structures.

Treatment of Spinal Cord Tumors

Ideally, the goal of spinal cord tumor treatment is to completely remove the tumor, but this goal can be complicated by the risk of permanent damage to the spinal cord and surrounding nerves. When determining the treatment plan, the type of tumor and whether it originates from the spine or spinal canal structures or has spread from anywhere in your body to your spine should also be considered.

Treatment options for most spinal tumors include:

• Follow-up: Some spinal tumors may be discovered before they cause symptoms—usually while being evaluated for another condition. If small tumors are not growing or pressing on surrounding tissues, all it takes is to watch them carefully. During the observation, your doctor will likely recommend periodic CT or MRI scans at appropriate intervals to monitor the tumor.
• Surgery: This is usually the treatment of choice for tumors that can be removed with an acceptable risk of spinal cord or nerve injury. Newer techniques and tools allow neurosurgeons to reach tumors once thought to be inaccessible. High-power microscopes used in microsurgery make it easy to separate the tumor from the healthy tissue. It can monitor the functions of the spinal cord and other important nerves during surgery, thus minimizing the possibility of injury. In some cases, very high-frequency sound waves can be used during surgery to break up tumors and remove fragments.

However, despite the latest technological advances in surgery, not all tumors can be completely removed. When the tumor is not completely removed, surgery may be followed by radiation therapy or chemotherapy, or both.

Recovery from spinal surgery can take weeks or longer, depending on the procedure. There may be a temporary loss of sensation or other complications such as bleeding and damage to nerve tissue.

• Radiation therapy: This can be used to remove tumor remnants left after surgery, to treat inoperable tumors, or to treat tumors where surgery is too risky. Medications can help relieve some of the side effects of radiation, such as nausea and vomiting. Sometimes your radiation therapy regimen can be adjusted to help minimize the amount of healthy tissue damaged and make the treatment more effective. Changes can range from simply changing the radiation dosage to using complex techniques such as 3-D conformal radiation therapy.
• Chemotherapy: A standard treatment for many types of cancer, chemotherapy uses drugs to destroy cancer cells or stop their growth. Chemotherapy can be given alone or in combination with radiation therapy. Side effects may include fatigue, nausea, vomiting, increased risk of infection, and hair loss.
• Other medications: Corticosteroids may sometimes be given to reduce edema after surgery or during radiation therapy, as the tumors themselves, along with surgery and radiation therapy, can cause inflammation in the spinal cord. Although corticosteroids reduce inflammation, they are usually only used for short periods of time to avoid serious side effects such as muscle weakness, osteoporosis, high blood pressure, diabetes and susceptibility to infection.