Overview 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). 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.
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Causes 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.
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Symptoms 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.
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Diagnosis 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.
Treatment 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.
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FAQs What are some of the symptoms of spinal cord tumors?
Numbness in the legs that is worsening
Back pain
Incontinence
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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