Overview | Causes | Symptoms | Diagnosis | Treatment | FAQ
Spinal cord tumors are abnormal growths of tissue found inside the
bony spinal column, which is one of the primary components of the
central nervous system (CNS).The presence of a tumor in the spinal area is extremely serious. These tumors may or may not be painful, which is why it is important to see a spine specialist when back or neck pain persists for more than a week. A tumor can place pressure on nearby nerve roots, which will cause pain.
Benign tumors are noncancerous, and
malignant tumors are cancerous. The CNS is housed within rigid, bony
quarters (i.e., the skull and spinal column), so any abnormal growth,
whether benign or malignant, can place pressure on sensitive tissues
and impair function. Tumors that originate in the brain or spinal
cord are called primary tumors.
Most primary tumors are caused by out-of-control growth among cells
that surround and support neurons. In a small number of individuals,
primary tumors may result from specific genetic disease (e.g., neurofibromatosis,
tuberous sclerosis) or from exposure to radiation or cancer-causing
chemicals. The cause of most primary tumors remains a mystery. They
are not contagious and, at this time, not preventable.
Spinal cord tumor symptoms include pain, sensory changes, and motor
problems. Symptoms generally develop slowly and worsen over time
unless they are treated. Tumors within the spinal cord usually cause
symptoms over large areas of the body, while tumors outside the spinal
cord may grow for some time before causing nerve damage. Other symptoms
include back pain, loss of sensation, muscle weakness, incontinence
and muscle spasms.
The first test to diagnose brain and spinal column tumors is a neurological
examination. Special imaging techniques (computed tomography, and
magnetic resonance imaging, positron emission tomography) are also
employed. Laboratory tests include the EEG and the spinal tap. A
biopsy, a surgical procedure in which a sample of tissue is taken
from a suspected tumor, helps doctors diagnose the type of tumor.
The tumor may be classified as benign or malignant and
given a numbered score that reflects how malignant it is. This score
can help doctors determine how to treat the tumor and predict the likely
outcome, or prognosis, for the patient.
Outlined below are some of the diagnostic tools that
your physician may use to gain insight into your condition and determine
the best treatment plan for your condition.
- Medical history: Conducting a detailed medical history
helps the doctor better understand the possible causes of your back
and neck pain which can help outline the most appropriate treatment.
- Physical exam: During the physical exam, your physician
will try to pinpoint the source of pain. Simple tests for flexibility
and muscle strength may also be conducted.
- X-rays are usually the first step in diagnostic testing
methods. X-rays show bones and the space between bones. They are
of limited value, however, since they do not show muscles and ligaments.
- MRI (magnetic resonance imaging) uses a magnetic field
and radio waves to generate highly detailed pictures of the inside
of your body. Since X-rays only show bones, MRIs are needed to visualize
soft tissues like discs in the spine. This type of imaging is very
safe and usually pain-free.
- CT scan/myelogram: A CT scan is similar to an MRI
in that it provides diagnostic information about the internal structures
of the spine. A myelogram is used to diagnose a bulging disc, tumor,
or changes in the bones surrounding the spinal cord or nerves. A
local anesthetic is injected into the low back to numb the area.
A lumbar puncture (spinal tap) is then performed. A dye is injected
into the spinal canal to reveal where problems lie.
- Electrodiagnostics: Electrical testing of the nerves
and spinal cord may be performed as part of a diagnostic workup.
These tests, called electromyography (EMG) or somato sensory evoked
potentials (SSEP), assist your doctor in understanding how your nerves
or spinal cord are affected by your condition.
- Bone scan: Bone imaging is used to detect infection,
malignancy, fractures and arthritis in any part of the skeleton.
Bone scans are also used for finding lesions for biopsy or excision.
- Discography is used to determine the internal structure
of a disc. It is performed by using a local anesthetic and injecting
a dye into the disc under X-ray guidance. An X-ray and CT scan are
performed to view the disc composition to determine if its structure
is normal or abnormal. In addition to the disc appearance, your doctor
will note any pain associated with this injection. The benefit of
a discogram is that it enables the physician to confirm the disc
level that is causing your pain. This ensures that surgery will be
more successful and reduces the risk of operating on the wrong disc.
- Injections: Pain-relieving injections can relieve
back pain and give the physician important information about your
problem, as well as provide a bridge therapy.
The goal when treating spinal cord tumors is to minimize nerve damage related
to compression of the spinal cord. The main priority is to administer treatment
as quickly as possible to prevent progression. The three most commonly used
treatments are surgery, radiation, and chemotherapy. Doctors also may prescribe
steroids to reduce the swelling inside the CNS.
What are some of the symptoms of spinal cord tumors?
- Numbness in the legs that is worsening
- Back pain
- Muscle spasms
- Cold feeling in the legs or hands
What is the prognosis?
The earlier the spinal cord tumor is detected, the better the outlook.
Without treatment, spinal tumors can lead to serious disability,
paralysis and death.
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