The spinal cord is a long bundle of nerves that extends from the brain along the length of the spinal column. The spinal cord is protected by three membranes called meninges and the vertebrae. Spinal tumours are abnormal uncontrolled growth of tissues or cells in the spinal cord. Tumours can either be cancerous (malignant) or non-cancerous (benign). Those that begin in the spine are called primary spinal tumours. Tumours that spread to the spine from other parts such as the breasts, prostate and lungs are called secondary spinal tumours. There are two types of tumours:
- Intramedullary tumours: starts in cells within the spinal cord
- Extramedullary tumours: develops from the network of cells that support the spinal cord (outer meninges). These are usually benign, but affect the functioning of the spinal cord by compressing the nerves.
The cause of primary spinal tumours is not known, but may occur from genetic defects, exposure to radiation and chemicals, or hereditary disorders such as neurofibromatosis and von Hippel-Lindau disease that interfere with the growth of cells.
Spine tumours may cause persistent and chronic back pain, numbness, burning and tingling sensations, bladder or bowel control problems, loss of sensation in the legs and arms, reduced sensitivity to heat, cold and pain, progressive muscle weakness, paralysis and difficulty balancing and walking.
Spine cancer can be diagnosed by reviewing your history and symptoms, and performing a thorough physical and neurological examination. Imaging tests such as biopsy (sample of the spinal tissue is removed for examination), myelogram (CT scan performed with a contrast dye), spine CT scan, spine MRI scan, and spine X-rays are usually ordered to confirm the presence of a spinal tumour.
Medications such as corticosteroids are prescribed to reduce inflammation and swelling around the spinal cord. Small benign tumours that do not compress surrounding nerves and show symptoms are closely monitored. Surgery is most often recommended to remove the tumour without affecting other important nerves. To minimize nerve damage, electrodes are used during the surgery to test the functioning of different nerves. In some cases, sound waves are used to break up the tumour, making it easier to remove the fragments.
When the tumour cannot be removed whole, and in cases of metastatic tumours or tumours that cannot be easily accessed, radiation therapy is performed to destroy the cancer cells. In order to avoid the ill effects of radiation on normal cells, your surgeon may perform stereotactic radiosurgery (SRS), where the radiation is targeted precisely on the tumour cells alone. Chemotherapy can be provided either alone or in combination with surgery and radiotherapy.