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Spinal

Spinal tumors take the form of diverse types of lesions ranging from benign (non-cancerous) tumors treated with surgical resection, to malignant (cancerous) tumors that require multidisciplinary care involving surgery, radiation therapy, and/or chemotherapy.

Image of pain-free spine metastases patient

Benign spinal tumors include meningiomas, neurofibromas, and schwannomas. These most often occur inside the spinal canal, but outside the spinal cord itself. These types of spinal tumors are most often treated with surgical resection alone, although more complex cases may also require additional therapy such as radiation or chemotherapy.

Malignant spinal tumors of the spinal column may be divided into two categories: the rare primary tumors, which arise in the bones of the spine, such as osteosarcomas, chordomas, and giant cell sarcomas; and the more common secondary, or metastatic tumors. Metastatic spinal tumors occur when cancer cells from another part of the body from cancers such as lung, breast, prostate, and colon spread to the spine either via direct extension or through the bloodstream. Spinal tumors of these types often need an aggressive multidisciplinary approach, possibly including surgery, spinal column reconstruction, radiotherapy, stereotactic radiosurgery and/or chemotherapy. Treatment from an experienced spinal oncologic surgeon is necessary for optimal results if surgery is required.


Types of Spinal Cord Tumors

Primary spinal cord tumors are those that originate in the spinal cord itself. These include astrocytomas, glioblastomas, ependymomas and hemangioblastomas. Differentiation of inflammatory or demyelinating spinal lesions of the spine from spinal cord tumors may be difficult. For this reason, surgery should be advised only after a thorough evaluation. For selected cases, microsurgical resection with an experienced neuro-oncologic surgeon will limit neurologic problems (morbidity), improve the chance for cure of less aggressive tumors (hemangioblastoma and ependymoma), and potentially improve survival for more aggressive ones (astrocytoma and glioblastoma). Aggressive types of spinal tumors often require the multidisciplinary approach of the Rose Ella Burkhardt Cleveland Clinic Brain Tumor and Neuro-Oncology Center's radiation therapists and oncologists in order to achieve long-term control.

Symptoms

Symptoms of spinal tumors and spinal cord tumors depend upon the location in the spine and upon the nerves that are affected. Many of these spinal tumors present with back or leg pain as their initial symptoms. Others may present with leg or arm weakness, clumsiness, or bowel or bladder problems.

How are they diagnosed?

CT (computed tomography) or MRI (magnetic resonance imaging) scans are most often used in the initial evaluation of spinal tumors and spinal cord tumors.

Treatment Options

The Rose Ella Burkhardt Brain Tumor Center aggressively treats primary and metastatic spine and spinal cord tumors. Ultrasound, microsurgery, and laser surgery are used by neurosurgeons during tumor removal; state-of-the-art fusion and stabilization techniques, including vertebroplasty and corpectomy, help restore functional mobility and relieve pain. Pain not amenable to direct surgical approaches may be treated with nerve blocks and catheters delivering medications directly to the spine. When these techniques fail, surgical techniques, including intrathecal pumps and cordotomy, often give dramatic pain relief to patients with spinal tumors. Radiation and chemotherapy often play roles in the comprehensive management of malignant spinal lesions. Radiation options may include standard fractionated radiotherapy and conformal spinal radiosurgery with the Novalis radiosurgical system.

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