The spinal column is known to be the most common location for bone metastasis (the spread of primary tumors from other sites in the body to the bone). It affects people of all age groups and the most common cancers that spread to the spine are renal, lung, breast and prostate.
Tumors that originate in the spine (primary spine tumors) are rare and most of the time are observed to have spread from other parts of the body to the spine (Metastatic).
The most common spinal tumors are as follows:
Vertebral Column Tumors
Primary tumors: Occurring in the vertebral column, they grow either from the disc elements of the spine or the bone. Usually occurring in young adults, Osteosarcoma (Osteogenic sarcoma) is an extremely common type of malignant bone tumor. Primary tumors not only grow slowly but also is very rare.
Metastatic tumors: Mostly, spine tumors spread metastasize from cancer present in another part of the body. These tumors are known to produce pain that worsens at night, doesn’t get better with rest and accompanied by other symptoms such as nausea, weight loss, vomiting, fever etc.
Since in most of the cases, this tumor is observed to have spread from advanced cancers in another part of the body, the goal of the treatment is to control the pain that is seen with these tumors. This is done by taking off the pressure on the nerve roots.
The neurological function is preserved by taking off the pressure on the spinal cord and the structural instability of the spine is fixed by reconstruction with a spinal fusion of the unstable spine.
Inside the dura (Intradural-extramedullary), tumors grow under the membrane that covers the spinal cord (spinal canal), but outside of the nerves. These tumors usually grow slowly and are benign but cause pain and weakness in the patient.
Meningioma (occurring in the membranes that surround the spinal cord) is malignant and benign and is usually seen in elderly and middle aged women.
Neurofibromas and Schwannomas (Nerve sheath tumors) that arise from the nerve roots (that come off the spinal cord). Even this tumor is slow to grow and benign and may take years before any neurological issues occur.
This type of tumor is usually surgically removed and neurological function is preserved.
As the nerves and spinal cord is extremely sensitive, the surgery is done with extreme efficiency and caution to avoid any form of damage to these structures. Post-surgery, rehabilitation is required to help the nerves completely heal and to improve neurological function of the patient.
If tumor adheres to the spinal nerves (and cannot be removed completely), postoperative radiation therapies may be used to improve the outcome. Chemotherapy may also help if the tumor is metastatic.
This type of tumor grows inside the nerves and arises from the cells that provide insulation and physical support to the nervous system. Mostly seen occurring in the cervical spine, they tend to be of 2 types: Ependymomas and Astrocytomas.
Similar treatment for Intradural-Extramedullary Tumors is used (radiation, chemotherapy and surgery)