Signs and Symptoms of Spinal Tumors: What to Watch For and When to Get Help

While rare, spinal tumors can press on nerves, cause permanent damage, and may be overlooked as everyday back pain. Nearly 85% of people experience back pain symptoms at some point in their lives. While most back pain is temporary and can be managed at home, some symptoms should be evaluated by a doctor. 

Although it’s rare that back pain indicates something as severe as a spinal tumor, both noncancerous (benign) and cancerous (malignant) tumors can develop in or around the spine, which extends from the base of the skull to the lower back, leading to a variety of symptoms. Therefore, pain that doesn’t respond to over-the-counter pain relievers or rest, pain that radiates to other areas of the body, or pain accompanied by any of the following symptoms should be evaluated promptly, as these may be first signs of a spinal tumor.

What are Spinal Tumors

A spinal tumor is an abnormal growth of tissue in or around the spinal cord or spinal column. These tumors can grow on the inside of the spinal cord, the meninges, which covers the spinal cord, the area between the meninges and your spinal bones, and inside your vertebrae.  These tumors can be noncancerous or cancerous and can cause a variety of symptoms, including pain, numbness, weakness, and bowel or bladder control problems.

Types of Spinal Tumors

There are many types of spinal cord tumors, and they are identified by where they develop within and along the spine and whether they are primary (develop in the spine) or metastatic (spread to the spine from another location in the body). The most common location for spinal tumors to develop is the mid and lower back.

 Types of spinal tumors include:

• Intramedullary spinal cord tumors develop in the cells of the spinal cord. They are not common and account for 20% of adult spinal tumors.
• Intradural Extramedullary spinal cord tumors develop in the protective membranes (dura) that surround the spinal cord. These are also rare, accounting for 20% to 30% of adult spinal tumors
• Extradural spinal cord tumors develop in bones or vertebrae surrounding the spinal cord, outside of the protective membrane. Extradural tumors are the most common, accounting for about 60% of adult tumors. 

Where Are Spinal Tumors Most Commonly Found?

Rarely, cancer develops in the spine. According to Yale Medicine, the lifetime risk for developing a cancerous spinal tumor is less than 1%. However, several forms of non-cancerous tumors can develop in the spinal cord or surrounding tissues, including:

• Meningiomas — develop in the protective membrane surround the spinal cord and brain.
• Nerve sheath tumors — develop from cells that form the myelin sheath around nerves or in the supporting cells in the nerve.
• Hemangiomas — develop from abnormal blood vessels.
• Osteoid osteoma/Osteochondroma — develop in the bones of the vertebrae and spine.

Noncancerous tumors can weaken the spine causing instability and fractures or press against the spinal cord and surrounding nerves, leading to pain, numbness, and even paralysis. If left untreated, these tumors can cause permanent damage and loss of function.

Other types of cancerous tumors that can develop in the spine include gliomas, which are a type of tumor that develops in the supportive cells of the spinal cord. The category encompasses several tumors named for the type of cell they originate from, including:

• Astrocytoma, which develops from astrocyte cells, which support nerve cells and can be either benign or malignant.
• Ependymoma, which is a primary tumor that develops from ependymocyte cells in the fluid-filled space that line the spinal cord. 
• Glioblastoma also develops from astrocyte cells and is considered a high-grade astrocytoma. It is considered very aggressive because it grows and spreads quickly resulting in a poor survival 5-year rate of only 5%.
• Oligodendroglioma, which starts in cells called oligodendrocytes that help support nerve fibers. 

Most spinal tumors are metastatic tumors, meaning they are cancerous tumors that originated in another part of the body and spread to the spine. Up to 70% of patients with cancer will experience a metastatic spinal tumor. Types of cancers known to spread to the spine include lung, breast, and prostate cancers, as well as blood cancers such as lymphoma and myeloma. 

Early Signs and Symptoms of Intradural and Extradural Spinal Tumors

• Numbness, tingling, or weakness in the arms or legs
• Loss of bowel or bladder control 
• Loss of coordination or difficulty with balance

Diagnosing Spinal Tumors 

To diagnose a spinal tumor, doctors will perform a full physical and neurological evaluation, including imaging tests, and in some cases, biopsies will be performed to determine the exact type of tumor. Magnetic resonance imaging (MRI) and computed tomography (CT) are the most common imaging tests. MRIs can show the spinal cord and surrounding tissues, including nerve roots and tumors, and CT scans can provide a detailed view of the bony structures of the spine. Additional tests like bone scans or myelography with X-ray can further help to assess any abnormalities in the spinal area and the severity of nerve compression.

Treatment Options for Spinal Tumors

The goal of spinal tumor treatment is to relieve pressure on the spinal cord and surrounding nerves, minimize pain, and prevent permanent damage. This can be achieved in several ways and will depend on the location and size of the tumor, whether it is cancerous or noncancerous, and whether it is a primary or metastatic tumor. A combination of therapies may be used, including chemotherapy, radiation therapy, and surgery.

If the spinal tumor is small, benign, and not causing severe symptoms, the doctor may recommend monitoring it carefully with periodic MRI and/or CT scans. 

For tumors that are causing symptoms and can be removed with low risk of spinal cord or nerve damage, microsurgery may be recommended. The surgeon will use a high-powered microscope to distinguish the tumor from healthy tissue and minimize the chance of injury during removal. For tumors that can’t be removed completely, surgery may be followed by chemotherapy, radiation therapy, or both. 

Recovery and Outcomes for Patients with Spinal Tumors

Recovery from spinal tumor surgery can take several weeks to months depending on factors like the type and size of the tumor and the complexity of the surgery. Patients with metastatic spinal tumors generally have a worse outlook following diagnosis and treatment, as those tumors have spread from a cancer elsewhere in the body. 

FAQ:

At New Jersey Brain and Spine, our specialists diagnose and treat a wide range of spinal tumors using advanced imaging and neurosurgical techniques.