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.
TriCities Spine in Bristol, TN is a by-product of discussions with case managers, rehab nurses and managed care experts on a local and national level who believe that spine care can be improved through a multidisciplinary team approach. TriCities Spine includes a board-certified neurosurgeon who specializes in spine, Dr. Jim Brasfield, teamed with a pain management specialist and spine-specialized physical therapy. TriCities Spine physicians already see a variety of complex cases from across Eastern Tennessee, Virginia, North Carolina and Kentucky. TriCities Spine emphasizes a nonsurgical approach to back pain, recognizing that in most cases spine surgery should be the last card to be played after nonsurgical options have been tried. About half of patients are referred to TriCities Spine by other doctors in the region. TriCities Spine also cares for those who injure themselves at the workplace. The strength of TriCities Spine lies in the medical expertise brought in by a variety of specialists who complement each other, including experts in physical medicine and neurosurgery. An internal pain specialist is often able to relieve some back and neck pain symptoms with special injections that enable a patient to bridge to therapy. Dr. Fred Terry specializes in pain relieving lumbar spinal injections and as well as myelograms, which may reveal the amount of damage in the spine. Therapists who specialize in spine use customized hands-on treatments to relieve pain symptoms, along with special exercises to help make the back stronger, more flexible and resistant to injury. If nonsurgical treatments are not successful, Dr. Jim Brasfield is trained and proficient in the latest techniques in minimally invasive spine surgery. Because of the minimally invasive techniques used by Dr. Brasfield, many patients are able to have their spine surgery and then return home the same day to recover in the comfort of their own home.