Spinal Cord Tumors
There are several types of spinal cord tumors. This information describes these tumors, their symptoms, tests and investigations, and possible treatments.
The spine and spinal cord
All the functions and senses of the body are controlled by the nervous system. This system is made up of the brain, spinal cord and a network of peripheral nerves that spread throughout the body from the spinal cord (see diagram below). The brain and spinal cord are known as the central nervous system (CNS).
The spinal cord stretches from the base of the brain down, inside the bones of the backbone, which is also known as the spine or the spinal column. The spinal cord doesn’t reach the full length of the spine but ends in the small of the back (the lumbar area).
The spinal cord is surrounded and protected by the backbone. The backbone is made up of bones called vertebrae. The peripheral nerves spread out from between these vertebrae.
There are 26 vertebrae in the spine:
- 7 cervical (neck)
- 12 thoracic (chest area)
- 5 lumbar (lower back)
- the sacrum (pelvic area) and the coccyx (tail bone).
The sacrum and the coccyx are made up of a number of bones, which are joined or fused together. There are five bones in the sacrum and four in the coccyx.
The meninges and cerebrospinal fluid (CSF) also surround and protect the brain and spinal cord. The meninges are membranes made up of three layers: dura mater (outer layer), arachnoid mater (middle) and pia mater (inner).
The spinal cord provides communication between the brain and the rest of the body. For example, if we want to pick something up, the brain sends an impulse down the spinal cord and along the nerves that control the functions of the hand.
Nerve impulses can travel up or down the spinal cord. If the object we pick up is soft to touch, an impulse travels up the spinal cord to the brain and tells us the object has a pleasant feeling. These are known as motor and sensory impulses.
The central nervous system
Spinal cord tumors
Cells within the CNS normally divide and grow in an orderly and controlled way. But if, for some reason, this process gets out of control, the cells keep dividing and form a lump or tumor.
Tumors are either benign or malignant. A benign tumor (not cancerous) can keep growing but cannot spread anywhere else in the body. In a malignant tumor (cancerous), the cells can grow into and destroy surrounding tissue. The cancer cells may spread to other parts of the CNS. Tumors affecting the CNS are rare.
Intradural extramedullary tumors
These start inside the coverings of the spinal cord, but outside the cord itself. Meningiomas and nerve-sheath tumors, such as schwannomas, are the most common types of intradural extramedullary tumors.
Extradural spinal tumors
Some tumors start in the bones of the spine. These are primary bone tumors and there are several different types. Benign tumors include osteomas and osteoblastomas. Malignant tumors include osteosarcomas, chondrosarcomas, chordomas andfibrosarcomas.
Secondary bone cancers
Some cancers can spread into the bones of the spine (vertebrae) from elsewhere in the body. These are known as secondary bone cancers. The most common primary cancers to spread to the vertebrae include lymphoma, lung, breast and prostate cancer. Myeloma is a cancer of the plasma cells, which commonly affects the vertebrae. This section does not cover secondary cancer of the spine or myeloma.
Causes of spinal cord tumors
What causes tumors that start in the spinal cord or the membranes (meninges) covering the spinal cord is not known. Research is being done to find possible causes.
Signs and symptoms of spinal cord tumors
These depend on the position of the tumor in the spinal cord. Spinal tumors often cause symptoms by pressing on the spinal nerves. Common symptoms include back and neck pain, numbness, and tingling and weakness in the arms or legs, or both.
Other symptoms can be clumsiness and difficulty walking. Tumors in the lower part of the spinal cord may cause loss of bladder and bowel control (incontinence).
Tests and investigations for spinal cord tumors
Your doctors need to find out as much as possible about the type, position and size of the tumor, so they can plan your treatment. You may have a number of tests and investigations.
CT (computerized tomography) scan
A CT scan takes a series of x-rays which build up a three-dimensional picture of the inside of the body. The scan is painless and takes 10-30 minutes. It uses a small amount of radiation, which is very unlikely to harm you or anyone you come into contact with.
You will be given an injection of a dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. It’s important to let your doctor know if you’re allergic to iodine or have asthma, because you could have a more serious reaction to the injection.
MRI (magnetic resonance imaging) scan
This test is similar to a CT scan but uses magnetism instead of x-rays. It builds up a detailed picture of areas of your body. Before the scan, you may be asked to complete and sign a checklist to make sure it’s safe for you.
Before the scan, you’ll be asked to remove any metal belongings, including jewelry. Some people are given an injection of dye into a vein in the arm. This is called a contrast medium and can help the images from the scan to show up more clearly. During the test you will be asked to lie very still on a couch inside a long cylinder (tube), for about 30 minutes. It’s painless but can be slightly uncomfortable, and some people feel a bit claustrophobic. It’s also noisy, but you’ll be given earplugs or headphones.
Treatment for a spinal cord tumor
The treatment for a spinal tumor depends on a number of things including your age and general health, along with the position, size and type of the tumor. The results of your tests will enable your doctor to decide on the best treatment for you. There are some risks associated with treatment to the spine and your doctor will discuss these with you.
Your treatment will usually be planned by a team of specialists. This multidisciplinary team (MDT) will usually include:
- a neurosurgeon (a doctor who operates on the brain and spine)
- a neurologist (a doctor who specializes in treating illnesses of the brain and spine)
- an oncologist (a doctor who specializes in treating brain and spinal tumors)
- a specialist nurse and possibly other healthcare professionals, such as a physiotherapist or dietitian.