Spinal tumors are abnormal growths on the spinal cord or column. AHN Spine Center provides care with minimally invasive and robotic techniques as well as traditional treatment options including surgical excision/debulking and radiation treatment.
What are spinal tumors?
When a tumor of the spinal cord develops, it can cause debilitating pain that affects everyday movements. Sometimes, spinal tumors can even pose a threat to your long-term health. The experts at the AHN Spine Center, an integrated part of AHN Neuroscience Institute, can help you navigate this potentially debilitating health condition using the latest in advanced technology.
Where do spinal tumors grow?
Spinal tumors can occur in different places:
- Inside the spinal cord itself: These can develop within the spinal cord tissue, and they are called intramedullary tumors.
- On the protective layers around the spinal cord: This protective layer is called the dura. The tumors that grow here are called intradural extramedullary tumors.
- On the bones of the spine: Tumors can sometimes grow on the vertebrae and include chordomas and osteosarcomas.
Sometimes, a tumor starts in your spine. More often, cancer from somewhere else in your body (like your lung or breast) can spread to your spine. Your AHN care team is made up of experienced healthcare providers who are experienced in treating the various types of spinal tumors and can determine a treatment plan that is specific to your specific diagnosis.
AHN Spine Center
Our board-certified spine specialists have decades of experience in diagnosing and treating rare tumors of the spinal cord. When possible, we perform the most advanced minimally invasive spine surgeries and are skilled in groundbreaking robotic techniques. These tools help us reach our ultimate goal: providing you maximum results and symptom relief. If you require more traditional surgery methods, our team can guide you through pre- and post-surgery to help you achieve the best health outcomes available.
Using a multidisciplinary team approach that is comprised of neurosurgeons, orthopedic spine surgeons, oncologists, and highly skilled nursing and rehabilitation specialists, we can deliver unmatched intervention for spinal conditions. Our advanced diagnostic capabilities allow us to get detailed images of the affected area to pinpoint our treatment options. This patient-centered care puts you and your needs at the center of this team-based approach, so all your providers are working in tandem to help improve your health options.
Advanced certification in spine surgery
AHN’s Allegheny General Hospital is the first hospital in Pennsylvania to have earned The Joint Commission's Gold Seal of Approval® for Advanced Certification in Spine Surgery, recognizing its commitment to safe, high-quality patient care and continuous compliance with rigorous performance standards. The Joint Commission is an independent, nonprofit organization that evaluates and accredits health care organizations nationwide.
Spinal tumors symptoms and signs
The problems caused by a spinal tumor usually get worse over time. They depend on where the tumor is, how big it is, and what kind of tumor it is. There are often some significant symptoms and signs patients experience. It can be good to speak with your doctor if you notice any consistent changes in your body or increasing pain.
Back pain
As the most common spinal tumor symptom, the pain might feel like it's in your:
- Neck
- Middle back
- Lower back
This pain might spread to other parts of your body, like your arms, legs, or chest. It can get worse when you cough, sneeze, or strain, and it often feels worse when lying down.
Numbness, tingling, or weakness
You might feel like part of your body is "asleep" or has pins and needles. This can happen in your arms, legs, or chest area. It can come and go or gradually worsen over time. Another sign can be that your muscles might feel weak, making it hard to walk, stand up, or hold things. You might stumble or have trouble with balance.
Changes in how your body works
Some other spinal tumor symptoms may include:
- Trouble with balance or walking: You might feel unsteady on your feet.
- Loss of sensation: You might not feel hot or cold temperatures as well as you used to.
- Problems with bladder or bowel control: You may have trouble going to the bathroom. This is a very serious symptom and needs urgent medical attention.
- Muscle spasms or stiffness: Your muscles might feel tight or twitch slightly.
- Deformity of the spine: In some cases, the tumor can cause the spine to curve (like scoliosis).
Spinal tumors screening and diagnosis
Since spinal tumor symptoms can be similar to many other problems, doctors need ways to check and confirm a spinal tumor diagnosis.
Doctor's visit and physical exam
Your doctor will first ask you questions about your health. They'll want to know about your symptoms: when they started, what they feel like, if anything makes them better or worse, and your past medical history. Your doctor will likely do a physical exam that may include checking your:
- Reflexes
- Muscle strength
- Balance
- How well you can feel things (like light touch and hot or cold temperatures).
This combination of tests and exams will help them understand how your nerves are working and help determine next steps.
Magnetic resonance imaging (MRI)
An MRI is usually the best and most common test to look for spinal tumors. It uses strong magnets and radio waves to create very detailed pictures of your:
- Spinal cord
- Nerves
- Soft tissues
Sometimes, your provider may order an MRI with contrast to make any potential tumors show up even better. This is a safe and effective way for doctors get the images they need for diagnosis.
Computed tomography (CT scan)
A CT scan uses X-rays to make cross-sectional (two-dimensional) pictures of your spine. It's especially good for looking at the bones of the spine and can be helpful in emergencies or if an MRI isn't possible.
Positron emission tomography (PET scan)
This test uses a small amount of radioactive tracer called FDG to find areas in your body where cells are very active, like cancer cells. It can be used to see if a tumor is cancerous and if it has spread from or to other parts of the body. Sometimes a PET scan is combined with a CT scan (PET/CT) for even more information.
Biopsy (taking a sample)
If the imaging tests suggest there might be a tumor, the doctor usually needs to do a biopsy to confirm it. This means taking a small piece of the tumor tissue for testing. A doctor (often a surgeon) will carefully remove a tiny sample of the tumor, usually with a needle or during surgery. This sample is then sent to a lab where another doctor (a pathologist) looks at it under a microscope to figure out exactly what kind of cells they are. This helps confirm if it's a tumor, if it's cancerous, and what type cancer it may be. This information is crucial for planning the best treatment.
Types and grades of spinal tumors
Spinal tumors are often grouped by where they grow and whether they started in the spine or spread there from somewhere else. Examples of spinal tumors include:
- Intramedullary tumors: These rare tumors grow inside the spinal cord itself.
- Intradural extramedullary tumors: These tumors grow outside the spinal cord but still inside the protective layers that surround it. They are the most common type of primary spinal tumor (meaning they start in the spine).
- Extradural tumors: These tumors grow outside all the protective layers, usually involving the bones of the spine (vertebrae). Most often, these are metastatic tumors (meaning they started somewhere else in the body and spread to the spine).
Spinal tumor grades
There isn't one universal staging system for all spinal tumors. Instead, doctors use a grading system to describe how aggressive the tumor cells look under a microscope. Ways to classify primary spinal tumor grades include:
- Low-grade: The cells look more like normal cells and grow slowly. These are usually benign or less aggressive.
- High-grade: The cells look very abnormal and are likely to grow and spread quickly. These are usually malignant (cancerous).
- Size of the tumor: Doctors will want to know if it has spread to other areas of the spine or outside the spine (though this is rare for primary spinal tumors).
Spinal tumor treatment
At AHN, our goal is to provide you significant relief in the least invasive way possible. After a thorough evaluation, we work together to develop a treatment plan that addresses your condition and needs. This collaborative approach provides you with a high level of personalized care.
Our care team considers many factors, including your age and the specifics of the tumor, when determining which treatments will benefit you. We may recommend more than one therapy, or treatments in a specific order, to increase their effectiveness.
Your spinal tumor treatment plan may include:
- Radiation therapy: With advanced computer software and imaging technology, our radiation oncologists deliver high-dose radiation beams directly to a tumor while protecting surrounding healthy tissue. We have a dedicated radiation oncology network to support your needs.
- Medical oncology: Chemotherapy uses medicines to kill cancerous tumors through an IV or port (a catheter that delivers medicine under the skin). We also offer a range of advanced therapies:
- Targeted therapy medications attack certain types of cancer cells, stopping the tumor’s growth.
- Immunotherapy uses the body’s natural defense system, the immune system, to destroy cancer cells.
- Surgery: If we recommend surgery, you will benefit from our world-class expertise in groundbreaking techniques and advanced technologies. We use minimally invasive techniques such as OsteoCool™ as well as innovative robotics technology to perform safe, effective surgeries. Our commitment to advanced care also includes stereotactic radiosurgery (SRS) for spinal tumors. SRS is a sophisticated, non-invasive radiation therapy that uses highly focused radiation beams to destroy tumor cells with exceptional precision, often in a single or a few treatment sessions, helping to preserve healthy spinal cord function. Learn more about our minimally invasive approach to spine and back surgery.
Spinal tumor symptoms and FAQs
For a potential patient, understanding a spinal tumor diagnosis can be daunting, but knowledge is the first step toward effective management and peace of mind. Spinal tumors are abnormal growths that can develop within the spinal column or directly on the spinal cord. While the idea of a tumor in this critical area can be frightening, it's important to remember that not all spinal tumors are cancerous, and many are treatable, especially when detected early. This guide aims to answer some frequently asked questions to help you better understand spinal tumors and what to expect.
What does pain from a spinal tumor feel like?
Pain is often the first and most common symptom of a spinal tumor. This pain is typically localized to the area of the tumor, such as the back or neck, but it can also radiate to other parts of the body, including the arms, legs, hips, or feet. The characteristics of the pain can vary significantly:
- Location-specific: Pain is often felt directly over the tumor site in the spine.
- Progressive: It often starts subtly and gradually worsens over time, sometimes becoming severe.
- Worse at night or with rest: Unlike mechanical back pain, which often improves with rest, tumor-related pain can intensify when lying down or during sleep, sometimes waking the patient.
- Neuropathic component: If the tumor presses on nerves, the pain can be sharp, shooting, burning, or tingling (nerve pain). It might be accompanied by numbness or weakness in the areas supplied by the affected nerves.
- Aggravated by activity: Certain movements, coughing, sneezing, or straining can sometimes worsen the pain.
- Not relieved by typical treatments: The pain often doesn't respond well to common over-the-counter pain relievers or conventional physical therapy, which is a red flag for deeper issues.
What are the odds of a spinal tumor being cancerous?
The odds of a spinal tumor being cancerous depend significantly on whether it's a primary or metastatic tumor.
- Primary spinal tumors (originating in the spine/spinal cord): A significant portion of primary spinal tumors are benign (noncancerous). For example, meningiomas and schwannomas, which are common primary spinal tumors, are typically benign. However, some primary tumors, like ependymomas (though often low-grade), astrocytomas, and chordomas, can be malignant (cancerous). Overall, the incidence of primary malignant spinal tumors is relatively low.
- Metastatic spinal tumors (spread from cancer elsewhere): These are far more common than primary spinal tumors, especially in adults. Metastatic tumors are, by definition, cancerous, as they represent cancer cells that have traveled from an original tumor site (e.g., lung, breast, prostate, kidney, thyroid) to the spine.
Therefore, while many primary spinal tumors are benign, a large majority of all spinal tumors encountered in clinical practice are metastatic and thus cancerous. A biopsy is often necessary to definitively determine if a spinal tumor is benign or malignant.
How long can you have a spinal tumor without knowing?
It is possible to have a spinal tumor for an extended period without knowing, sometimes for months or even years. This is particularly true for slow-growing, benign tumors.
- Slow-growing tumors: Benign tumors like meningiomas or schwannomas can grow very slowly. They may only produce subtle symptoms, or no symptoms at all, until they reach a size where they begin to compress the spinal cord or nerve roots significantly.
- Nonspecific symptoms: Early symptoms, such as mild back pain, might be dismissed as common aches and pains, leading to delays in diagnosis.
- Location: Tumors in less critical areas or those that don't immediately compress neurological structures may remain silent for longer.
- Incidental findings: Some spinal tumors are discovered incidentally during imaging scans performed for unrelated conditions.
However, more aggressive or rapidly growing tumors, especially malignant ones, tend to cause symptoms that escalate more quickly, leading to earlier diagnosis. If symptoms like persistent pain, weakness, numbness, or changes in bowel/bladder function develop, it's crucial to seek medical attention promptly.
What are the symptoms of spinal tumors?
Spinal tumor symptoms vary widely depending on the tumor's size, location, type, and growth rate, but they often include:
- Pain: Localized back or neck pain, often worsening at night or with activity, and not relieved by rest or common pain relievers. This is the most common symptom.
- Neurological deficits:
- Weakness: In the arms, legs, or both, which can range from mild to severe, affecting balance and coordination.
- Numbness or sensory loss: Reduced sensation, tingling, or a "pins and needles" feeling in the limbs or torso.
- Changes in gait: Difficulty walking, stumbling, or loss of balance.
- Muscle spasms or cramping: In the affected areas.
- Bowel or bladder dysfunction: Difficulty with urination (hesitancy, incontinence) or bowel movements (constipation, incontinence). This is a serious symptom requiring urgent evaluation.
- Spinal deformity: In some cases, a tumor affecting the vertebrae can lead to a noticeable curve in the spine (scoliosis or kyphosis).
- Temperature sensitivity: Unusual sensitivity to hot or cold temperatures.
- Changes in reflexes: Exaggerated reflexes or absence of reflexes.
It's important to note that many of these symptoms can also be caused by other, more common conditions. Therefore, a thorough medical evaluation is necessary for an accurate diagnosis.
What is the prognosis for a spinal tumor?
The prognosis for a spinal tumor is highly variable and depends on several critical factors:
- Type of tumor: Benign tumors generally have an excellent prognosis, especially if completely removed. Malignant tumors have a more guarded prognosis, which varies depending on the specific cancer type.
- Location and size: Tumors that can be fully resected (surgically removed) without causing significant neurological damage tend to have a better outcome. Tumors that are large, have invaded surrounding critical structures, or are difficult to access surgically may have a poorer prognosis.
- Stage (for malignant tumors): Whether the cancer has spread (metastasized) from the spine to other parts of the body, or vice versa, significantly impacts prognosis. • Patient's overall health: Age, general health, and presence of other medical conditions can influence treatment tolerance and recovery.
- Response to treatment: How well the tumor responds to surgery, radiation therapy, chemotherapy, or other targeted therapies.
- Neurological status at diagnosis: Patients with minimal neurological deficits at the time of diagnosis often have better functional outcomes after treatment compared to those with significant weakness or paralysis.
Advancements in surgical techniques, radiation therapy (like stereotactic radiosurgery), and systemic therapies have significantly improved outcomes for many patients with spinal tumors. Early diagnosis and treatment at a specialized center can be extremely helpful in early diagnosis. Follow-up care is essential to monitor for recurrence and manage any long-term effects of the tumor or its treatment.
Contact us
To schedule an appointment or learn more about AHN neuroscience services, call 412-359-6200 or 814-452-7575 in Erie.
If you're an existing patient, you can also call (412) DOCTORS 412-362-8677 for Erie call 814-CONNECT, or request an appointment with AHN neuroscience services.