Tumor and spine — two words we do not relish hearing in the same sentence. When speaking about medical conditions, both the spine and tumors are not to be taken lightly. Whether benign or malignant, a tumor can cause pain and menace your daily life. There are several different types of and causes for spinal tumors, but each one requires professional medical attention.
What is a Spinal Tumor?
To understand spinal tumors, one must first understand the basic structure of the spine. The long stack of bones along your back is called the backbone or spine. A flexible column, the spinal cord encases the spinal column, protecting it from daily impact. Running from the base of the skull to the end of your tailbone, the backbone safeguards nerve bundles and cells in the central nervous system responsible for delivering messages from the brain and spinal cord to the rest of the body (or vice versa). A spinal tumor is so named because it is located within or near the spinal cord or spinal column. Spinal tumors are abnormal tissue masses with cells that uncontrollably grow and multiply. There are two primary spinal tumor types:
- Benign tumors or non-cancerous;
- Malignant tumors or cancerous.
Spinal tumors are further categorized as:
- Primary spinal tumors: They stem from the spine or spinal cord.
- Metastatic tumors (secondary tumors): They develop after cancer has spread from a different site to the spine.
While the exact cause of most primary spinal tumors is still largely considered a mystery, there are some known causes and connections such as:
- Exposure to cancer-causing agents;
- Compromised immune systems;
- Blood vessel connection.
Compromised immune systems can result in certain primary spinal tumors such as spinal cord lymphomas, which attack immune cells called lymphocytes. Genetics and neurological disorders can also contribute to one’s propensity to develop primary spinal tumors. For example, neurofibromatosis 2 is hereditary and begins as benign lesions that develop on or near nerves related to hearing. Extensive neurofibromatosis 2 can lead to hearing loss in one or both ears, and those suffering from this disorder are also known to develop spinal canal tumors. Finally, some primary spinal tumors are connected to blood vessels. For example, von Hippel-Lindau disease is a rare multisystem disorder that causes tumors in the blood vessels connected to the brain, retina, or spinal cord. Other primary spinal tumors in the kidneys or adrenal glands also result from this spinal disease.
What are the Different Spinal Cord Tumors?
There are four different types of spinal cord tumors, categorized by the spinal region they affect:
- Cervical, which affects the neck area;
- Thoracic, which affects the upper to mid back;
- Lumbar, which affects the lower back;
- Sacrum, which affects the bottom of the spine.
Spinal cord tumors are further classified as one of the following based on their location within the spine:
An intradural-extramedullary tumor is located within the thin covering or dura of the spinal cord but is still outside the actual spinal cord. Tumors are found within this area about 40% of the time and are either in the spinal cord’s arachnoid membrane, in the spinal cord nerve roots which branch out from the spinal cord, or at the base of the spinal cord. While tumors in the arachnoid membrane are frequently benign, they are also challenging to remove and may reappear. Also, often benign, nerve root tumors may become malignant through time. Finally, the tumors at the spinal cord base can be large, causing difficulty removing them from the more delicate and fine neural structures.
Intramedullary tumors grow inside the spinal cord and typically stem from glial cells found throughout the spinal cord’s interstitium. About 5% of tumors occur in this region. Astrocytomas and ependymomas are two of the most common types of intramedullary tumors. Also generally benign, these tumors can be difficult to remove.
Finally, extradural tumors are found outside of the dura. Tumors grow in this area approximately 55% of the time. Typically, these tumors come from metastatic spinal cancer or, less commonly, from schwannomas from cells that cover nerve roots. Sometimes, extradural tumors can poke through the intervertebral foramina, causing it to lie between the inside and outside of the spinal canal.
What Percentage of Spinal Tumors are Benign?
While we all wished that osseous spinal tumors were always benign, that is not always the case. There are plenty of different types of spinal tumors that are benign, such as:
- Giant cell bone tumors;
Spinal osseous tumors occur in any part of the vertebrae, most often in the thoracic vertebrae or the sacral and lumbar spine — they rarely occur in the cervical spine. Those who are middle-aged or elderly are more likely to develop malignant spinal tumors. On the other hand, younger patients are more prone to benign tumors. Most spinal tumors are secondary or metastatic spinal tumors. Almost 97% of all spinal tumors are metastatic, and about 10,000 people in the United States are diagnosed yearly with metastatic spinal cord tumors. Approximately 30% to 70% of cancer patients will develop cancer metastasis in their spine. More uncommon, benign primary spinal tumors make up about 0.5% of all newly diagnosed tumors. However, malignant primary spinal tumors are considered even more uncommon.
Spinal Tumor Early Symptoms
The type of symptoms for early diagnosis develops based on the following factors:
- The tumor location within or along the spinal column;
- The tumor size;
- The type of tumor.
However, symptoms sometimes fail to develop based on the tumor size! If the tumor is small and does not pressure or irritate nearby tissues, a patient will probably not experience any symptoms. However, once it increases in size, the tumor can cause different painful or uncomfortable symptoms along the spinal column. The most common symptom of either a benign or malignant spinal tumor is back pain and muscle weakness. Tumors are more likely to develop in the spine’s middle or lower back regions. As such, the pain will often target these spinal areas. While back pain is not uncommon in more elderly or particularly active individuals, pain from a spinal tumor has some unique attributes. Pain caused by a spinal tumor is not specific to a previous injury or physical activity but can increase from exercising, sneezing, or coughing. Spinal tumor pain is also deep and aching, starting slowly and increasing gradually. At night, the pain can be increasingly persistent and disrupt sleep. As the tumor grows, the pain can become intense and cause disruption even while resting. Radicular pain spreads from the spinal column to the hips, legs, feet, or arms and is a painfully sharp and shooting symptom of spinal tumors. If the spinal tumor is in a specific location and grows to press on the spinal cord or nerve roots, blood vessels, or bones of the spine, then other symptoms such as the following may develop:
- Numbness, tingling, or loss of sensation in your legs, arms, or chest;
- Leg, arm, or chest muscle weakness;
- Muscle cramps or spasms;
- A stiff back or neck;
- Loss of bowel or bladder function;
- Difficulty walking;
- Scoliosis or a different spinal deformity resulting from a large, destructive tumor growth;
- Varying degrees and locations of paralysis, depending on the spinal nerves the tumor is compressing.
There are three main methods for diagnosing tumors:
- Spinal magnetic resonance imaging tests (MRI);
- Computerized tomography (CT scan);
Magnetic Resonance Imaging (MRI)
A magnetic resonance imaging or MRI is a special device that uses powerful magnetic fields and radio waves to create accurate images of your spine, spinal cord, and nerves. The preferred testing method, an MRI enables professionals to view the spinal cord and surrounding soft tissue. While some may become claustrophobic within an MRI scanner or find the loud thumping sound disturbing, your health care professionals have methods of making the experience more comfortable. Whether you use earplugs or a distracting device such as a TV or headphones, there are many different ways to overcome anxiety regarding your MRI. Sometimes, you may even be given a general anesthetic to make the process more comfortable.
Computerized Tomography (CT Scan)
Computerized tomography (CT scan) employs a narrow radiation beam to form detailed spinal images. It is sometimes combined with an injected contrast dye to make any abnormal growth in the spinal canal or spinal cord even clearer. However, unlike an MRI, a CT scan is rarely used to help diagnose a spinal tumor.
Finally, a biopsy is the only method to determine the specific type of spinal tumor you are dealing with. By taking a small soft tissue sample or biopsy and examining it under a microscope, a biopsy result can help determine the best spinal cancer treatment options for your situation.
Can Spinal Tumors Be Removed?
The good news is that spinal tumors can be removed! Radiation therapy, chemotherapy, or spinal surgery are three methods by which to evict these pesky tenants.
Although radiation therapy sounds scary, the basic process is actually rather simple. By using high doses of x-rays, this treatment for spinal tumor cells destroys or shrinks the tumor body. Once the tumor is small enough, the pain and other symptoms are reduced or eliminated.
Chemotherapy is a standard method to destroy spinal cancer cells. By taking chemotherapy drugs, any cancer cells found in your spine tumors will be eliminated. Either through injection into a vein or by ingesting a pill, healthcare providers use chemotherapy to shrink tumors before surgery or to kill them completely.
Spinal surgery is generally reserved for those with metastatic spinal tumors when they are estimated to live three to four months or longer, and the tumor is not responding to radiation or chemotherapy. Pain and other symptoms can be relieved when the spine is stabilized, and the neurological function is preserved. Neurological surgeons perform either traditional open surgery or a minimally-invasive procedure. It depends on the opinion of your spinal surgeons to perform vertebroplasty or kyphoplasty. Both of these procedures provide spinal cord support and stability, relieving pain and improving mobility. About 10% of patients with symptomatic spinal metastases are eligible for surgical treatment.
How Can Chiropractic Care Help with Spinal Tumors?
Chiropractic care can be useful in controlling pain, headaches, and tension. Some scientific evidence suggests that chiropractic treatment options may also relieve headaches and back pain. However, there is no substantial evidence that chiropractic treatment can prevent, treat, or cure spinal cancer. Thus, while it is a useful tool to manage painful symptoms, it is not at all a miracle cure for spinal tumors.
Do You Have More Questions Regarding Spinal Tumors? Dr. Doerr Can Help!
At the Bergen Chiropractic and Sports Rehabilitation Center, our chiropractic team, led by Dr. Gregory Doerr, follows the highest and most professional medical standards to provide superior chiropractic help. After all, our mission is to provide unparalleled patient care and services in a comfortable healing atmosphere. Access our contact form or call us at (201) 298-7179 or (201) 357-6539 to learn more about our chiropractic services! Our chiropractic offices at 532 Anderson Avenue, Cliffside Park, NJ 07010, and 62 Summit Ave, Hackensack, NJ 07601 are ready to welcome you as we proudly serve New York, New Jersey, Philadelphia, PA, and Baltimore, MD areas. Also, feel free to access our blog page and social media for more information on chiropractic treatments!