Overview of Spinal Cord Tumors

The spinal cord is the body’s main communication highway, running from the brain down through the spine. Protected by a series of vertebrae, this slim, tube-like structure is packed with nerves that relay vital information between your brain and the rest of your body. It’s the command center for everything from moving your muscles to sensing pain and temperature.

Without the spinal cord, your brain’s signals would never reach your arms, legs, or organs, and you wouldn’t be able to feel or respond to your environment. It’s the essential link that keeps your body in sync, making every movement and sensation possible.

Primary spinal cord tumors (tumors originating in the spine) are relatively rare, compared with tumors in other parts of the body. Secondary spinal cord tumors (those that originate in another part of the body) occur more often and are often associated with cancer in the lung, prostate, or breast.

The causes of spinal cord tumors are unclear. Most patients do not have an identifiable cause. However, certain genetic conditions (conditions passed down through a family) such as neurofibromatosis type 1 & type 2, as well as von Hippel-Lindau disease are known to be associated with spinal cord tumors. Radiation exposure has also been associated with a higher chance of developing a spinal cord tumor.

Although there are no proven ways to prevent the development of a spinal cord tumor, maintaining a healthy lifestyle and avoiding exposure to radiation can help your overall health. If you or a family member have a genetic condition such as neurofibromatosis or von Hippel-Lindau disease, genetic counselling could be beneficial. Regular medical examinations and screening might also be appropriate

Spinal cord tumors are abnormal growths that occur in the spine. These tumors can be either malignant (cancerous) or benign (noncancerous). Cancerous tumors can grow quickly and spread to other parts of the body, whereas noncancerous tumors usually grow slowly and stay in one place.

When a tumor forms in the spinal cord, it can put pressure on the nerves and affect how the spinal cord works, which can lead to different symptoms depending on where the tumor is. Spinal cord tumors are classified on the basis of their location.

• Intramedullary tumors arise from the spinal cord tissue itself
• Intradural-extramedullary tumors arise outside of the spinal cord tissue but within the membrane that covers and protects it (dura mater)
• Extradural tumors arise outside of the dura mater

Numerous types of spinal cord tumors exist, and they are classified based on how they look under a microscope. Each of these tumors has different characteristics and treatment strategies and result in different likely outcomes. The following are a few examples of common spinal cord tumors:

• Ependymomas are one of the most common types of spinal cord tumor, particularly in children. They usually develop from the ependymal cells that line the central canal of the spinal cord. Ependymomas usually grow slowly.
• Astrocytomas are tumors that develop from cells called astrocytes, which support and nourish nerve cells in the spinal cord. They can be either low grade (less aggressive) or high grade (more aggressive).
• Schwannomas are usually benign tumors that arise from the Schwann cells, which produce the protective covering (myelin) around nerves. They commonly occur in the spinal nerves and can cause pain, weakness, or numbness in the area supplied by the affected nerve. Schwannomas tend to grow slowly and can often be removed with surgery.
• Neurofibromas also develop from Schwann cells. They can occur along the nerve pathways throughout the body, including the spinal cord. Neurofibromas are typically benign, but in some cases, they can become cancerous.
• Meningiomas are tumors that develop from the meninges, which are the protective membranes that cover the brain and spinal cord. More commonly found in the brain, meningiomas can also occur in the spine. They typically grow slowly and are often benign.
• Hemangioblastomas are rare tumors that develop from blood vessel cells and are often associated with a genetic condition called von Hippel-Lindau disease.

When a person has a spinal cord tumor, the symptoms they experience can vary depending on the tumor’s location, size, and type.

The following are some common symptoms that can occur:

• Pain: Spinal cord tumors can cause pain in different parts of the body. The pain might be localized in the back or neck where the tumor is located, or it can radiate to other areas such as the arms, legs, or chest.
• Weakness: Tumors in the spinal cord can press on the nerves, leading to weakness in the muscles. This weakness can affect the arms, legs, or both. It can make it difficult to move or perform daily activities.
• Changes in sensation: Spinal cord tumors can disrupt the normal transmission of sensory signals, which can result in numbness or tingling in the arms, legs, or other parts of the body. Some people might also experience a loss of sensation in certain areas.
• Difficulty walking: If the tumor affects the nerves that control leg movement, it can cause difficulty walking or problems with balance and can make it hard to walk properly or result in stumbling or unsteadiness.
• Changes in bowel or bladder control: Spinal cord tumors can interfere with the nerves responsible for controlling the bladder and bowels, which can lead to problems such as difficulty controlling urination or bowel movements.
• Muscle spasms: Some individuals can experience involuntary muscle contractions or spasms because of the tumor’s effect on nerve signals.
• Sexual dysfunction: Depending on the location of the tumor and the specific nerves affected, some people might experience a range of sexual problems, including erectile dysfunction, decreased libido, and altered genital sensation.

It is important to remember that these symptoms can be caused by various other conditions and experiencing them does not necessarily mean that you have a spinal cord tumor. It is essential to seek medical attention for back pain if you experience any of the following “red flag” signs.

• Fevers and chills
• Persistent pain
• Previous history of cancer
• Family history of cancer
• Other symptoms such as weakness, bowel or bladder disturbances, or tingling and numbness in the arms or legs.

Every person can have a unique combination of symptoms depending on the specific characteristics of their spinal cord tumor. Doctors and medical professionals work together to evaluate and diagnose spinal cord tumors and provide the most suitable treatment options for each patient.

Diagnosing a spinal cord tumor typically involves a combination of medical history evaluation, physical examinations, imaging tests, and, in some cases, biopsy (surgical sampling of the tumor for testing). The following is a brief overview of the diagnostic process.

• Medical history and physical examination: the doctor will begin by discussing the person’s symptoms, medical history, and any relevant family history. They will ask about the specific nature of the symptoms, their duration, and any factors that may worsen or alleviate them. During the physical examination, the doctor will assess neurological function, including strength, sensation, reflexes, and coordination.
• Imaging tests: a physician might order imaging tests to obtain more information about the tumor.
  • Magnetic resonance imaging (MRI)—the primary imaging test used to visualize spinal cord tumors; MRI uses powerful magnets and radio waves to create detailed images of the spinal cord and surrounding structures to help identify the location, size, and characteristics of the tumor
  • Computed tomography (CT)—used in some cases to obtain additional information; it uses radiography (x-rays) to create cross-sectional images of the spine and can help evaluate bone structures and detect certain types of tumors
• Biopsy: when the diagnosis remains uncertain or a tumor is suspected to be cancerous, a biopsy might be performed. Biopsy involves removing a small sample of the tumor tissue for examination under a microscope. This procedure can be done surgically; depending on the tumor’s location, it can be performed either traditionally (open surgery) or with minimally invasive techniques.
• Laboratory tests: blood tests might be conducted to evaluate general health, assess organ function, and detect any underlying conditions that could contribute to the symptoms. However, blood tests alone cannot confirm or rule out the presence of a spinal cord tumor.

The diagnostic process can vary depending on the specific case and the judgment of the health care team. Your care team will consider multiple factors to ensure an accurate diagnosis and determine the best course of treatment.

It can be an overwhelming and challenging experience to receive such news, and it's understandable to feel scared, confused, or anxious about what lies ahead. The medical professionals caring for you will work diligently to provide you with the best possible care and support. Surround yourself with loved ones who can offer comfort and encouragement.

Take things one step at a time and focus on your physical and emotional well-being. Reach out to a support group or organization that specializes in spinal cord tumors; the people in such groups can provide valuable information, resources, and a network of people who can relate to your experience.

• Spinal cord tumors can be either intramedullary, intradural-extramedullary, or extradural
• There is a wide variety of spinal cord tumors, depending on how they look under a microscope
• Primary spinal cord tumors arise from the spinal cord; secondary spinal cord tumors are spread from cancer in another part of the body
• Spinal cord tumors can cause a wide variety of symptoms such as neck or back pain, weakness in the arms or legs, tingling and numbness, bowel/bladder disturbances, and sexual dysfunction
• Diagnosis of a spinal cord tumor usually involves a thorough physical examination, imaging tests, and biopsy

• American Association of Neurological Surgeons (AANS): Spinal tumors
• Canadian Cancer Society (CCS): Supportive Care for Brain and Spinal Cord Tumors
• National Cancer Institute: Related organizations
• Cancer Support Community: Brain and spinal cord tumors