What are Spinal Cord Tumors?
Spinal cord tumors are abnormal growths of tissue that develop within or surrounding the spinal cord. They can be benign (non-cancerous) or malignant (cancerous) and may originate in the spinal cord itself (primary tumors) or spread from other parts of the body (secondary or metastatic tumors).
Types of Spinal Cord Tumors
Spinal cord tumors are classified based on their location in relation to the spinal cord:
- Intramedullary Tumors – Tumors that develop within the spinal cord itself are called intramedullary tumors. Examples include:
- Ependymoma – This is the most common type of spinal cord tumor. Ependymomas originate in the ependymal cells that line the central canal of the spinal cord.
- Astrocytoma – This type of tumor is more common in children. Astrocytomas originate in the astrocytes, star-shaped cells noted in the spinal cord and brain.
- Hemangioblastoma – This type of tumor can arise in any section of the spinal cord and typically contains several blood cells.
- Intradural–Extramedullary Tumors – Tumors that develop outside of the spinal cord but within the spinal canal are called intradural–extramedullary tumors. Examples include:
- Meningioma – A spinal meningioma originates in the thin membranes that surround the spinal cord. It typically appears in the upper part of the back and is usually common in women.
- Schwannoma - A schwannoma is comprised of Schwann cells that make the substance that envelops nerves. It is typically found within the dura, on the outside of the spinal cord.
- Neurofibroma – A neurofibroma originates in the protective covering of the spinal cord and nerves. It commonly occurs in individuals with neurofibromatosis, a condition that causes nerve tumors throughout the central nervous system and skin.
Causes of Spinal Cord Tumors
Spinal cord tumors are caused by genetic mutations that lead to abnormal cell growth. Some are linked to inherited conditions like neurofibromatosis type 2 (NF2) or von Hippel-Lindau disease, while others may be triggered by radiation exposure or carcinogenic chemicals. Metastatic spinal tumors originate from cancers in other parts of the body, such as the lungs, breasts, or prostate. In many cases, the exact cause remains unknown.
Symptoms of Spinal Cord Tumors
Symptoms depend on the tumor's size and location, but common signs include:
- Pain (persistent back or neck pain, often worse at night)
- Weakness, numbness, or tingling (in arms, legs, or trunk)
- Difficulty walking or balance issues
- Bowel or bladder dysfunction
- Paralysis (in severe cases)
Diagnosis of Spinal Cord Tumors
The diagnosis of spinal cord tumors involves a combination of imaging tests and clinical evaluation. MRI with contrast is the gold standard, providing detailed images of the spinal cord and detecting tumors. CT scans may be used to assess bone involvement. A biopsy is performed in some cases to determine whether the tumor is benign or malignant. Additionally, a spinal tap (lumbar puncture) may be used to analyze cerebrospinal fluid for tumor markers. Neurological exams help assess symptoms and guide further diagnostic steps.
Treatment for Spinal Cord Tumors
Treatment for spinal cord tumors depends on the tumor type, location, and severity of symptoms. Surgery is often the first-line treatment, especially for benign or accessible tumors, using microsurgical techniques to minimize nerve damage. If complete removal is not possible, radiation therapy, including stereotactic radiosurgery (SRS), may help shrink tumors and relieve pressure on the spinal cord. Chemotherapy is less commonly used but may be effective for certain aggressive or metastatic tumors, sometimes in combination with radiation. Emerging treatments like targeted therapy and immunotherapy focus on specific tumor characteristics to enhance effectiveness with fewer side effects. Additionally, steroids (such as dexamethasone) help reduce inflammation and swelling, improving symptoms. Supportive care, including pain management, physical therapy, and rehabilitation, plays a crucial role in maintaining mobility and quality of life.
