A Spinal Cord Tumour is defined as an abnormal proliferation of a mass of tissue within or surrounding the spinal cord and/or spinal column or within the bones of your spine. While a spinal tumour that chiefly begins within the spinal cord or the covering of the spinal cord (dura) is known as an intradural tumour, a tumour affecting the bones of the spine (vertebrae) is called a vertebral tumour. These tumours can be either benign (non-cancerous) or malignant (cancerous). In some cases, tumours from other parts of the body can metastasize to the vertebrae, the supporting network around the spinal cord or, in rare cases, the spinal cord itself.
Spinal tumours of any kind can often lead to intense pain, neurological problems and sometimes even paralysis. A spinal tumour can be life-threatening and cause permanent disability and chiefly require surgery, radiation therapy, chemotherapy or other medications.
Spinal Tumours are chiefly classified into three different types depending on where they occur relative to the protective membranes of the spinal cord and their exact location in the spine. These include:
Intradural-extramedullary Tumours: These tumours are mainly located inside the thin covering of the spinal cord (i.e., the dura), but outside the actual spinal cord. The most common types of intramedullary tumours develop in the spinal cord's arachnoid membrane (i.e., meningiomas), at the spinal cord base (i.e., filum terminale ependymomas), or in the nerve roots that extend out from the spinal cord (i.e., schwannomas and neurofibromas). Although these type of tumours are often benign, they can be difficult to remove and may recur.
Intramedullary Tumours: These tumours usually grow inside the spinal cord and are typically derived from the glial or ependymal cells. The two common types of Intramedullary Tumours are astrocytomas (in the thoracic region followed by the cervical) and ependymomas (found in the bottom region of the spinal cord, followed by the cervical region). They are often benign but can be difficult to remove.
Extradural Tumours: These types of tumours are mainly located outside the dura, which is the thin covering surrounding the spinal cord. The characteristic lesions are typically associated to metastatic cancer or less commonly schwannomas derived from the cells covering the nerve roots. Occasionally, an extradural tumour can extend through the intervertebral foramina, lying partially within and partially outside of the spinal canal.
Just like any other form of cancer, the exact cause of spinal tumour is yet unknown, but several research and studies suggest that it usually forms when there is a genetic mutation or defective genes in the cells of the spinal column or spinal cord leading to a rise of abnormally shaped cells that do not die and keep accumulating to form tumour-like structures. Then again, it is not known whether these defective genes are inherited or develop in one’s body over time. The genetic mutation can also happen by some environmental trigger, such as exposure to certain chemicals.
Certain causative factors that increase the risk of Spinal Tumours include:
Neurofibromatosis 2: People diagnosed with neurofibromatosis 2, a genetic benign tumour that develops in the arachnoid layer of the spinal cord or in the supporting glial cells, are more at risk of developing spinal canal tumours.
Von Hippel-Lindau Disease: This rare, multisystem disorder is associated with blood vessel tumours (i.e., hemangioblastomas) in the brain, retina and spinal cord and with other types of tumours in the kidneys or adrenal glands makes a person more prone to spinal tumour.
The characteristic symptoms of spinal cord tumours can differ especially as the tumours grow. It may affect the spinal cord or the nerve roots, blood vessels or bones of your spine. These signs and symptoms include:
- Pain at the site of the tumour due to tumour growth
- Stiff neck or back
- Pain and/or neurologic symptoms
- Decreased sensitivity to pain, heat and cold
- Loss of bowel or bladder function
- Difficulty in walking, sometimes leading to falls
- Intense back pain that worsens at night
- Loss of sensation, especially in your arms, legs or chest
- Muscle weakness, which may be mild or severe
- Paralysis in different parts of the body depending upon the suppressed nerve
- Scoliosis or other spinal deformity resulting from a large and/or destructive tumour
Diagnosis And Treatment
On noticing any of the above-mentioned signs and symptoms, consult a doctor at once to start the treatment at the earliest. The specialized doctor or neurologist usually does a thorough physical check-up, acknowledges the patient’s family history and past medical history and does a series of diagnostics which include:
Imaging Techniques including CT-scan, MRI-scan, PET-scan and Ultrasound to find the exact position of the tumour.
Biopsy to analyze the types of cells and their level of aggressiveness.
Treatment options usually include a team of doctors consulting to perform the best possible option to bestow the patient with a normal life. It is usually selected based upon the type, stage of cancer, location of the tumour and other factors like overall health, age, of the patient and sensitivity to certain medications. This includes:
- Surgery (includes removal of tumour and to relieve fluid build-up in the brain)
- Radiation therapy