Types of Spinal Tumors

Spinal tumors are abnormal tissue masses that form within the spinal canal or bones. They can be malignant (cancerous) or benign (noncancerous). This guide will explore the different types of spinal tumors, symptoms, diagnostic methods and treatment options.

Intramedullary vs. Intradural-Extramedullary Tumors

Doctors classify spinal tumors based on their location. These tumors fall into the two categories below.

Intramedullary Tumors

Intramedullary tumors develop in the glial or supporting cells within the spinal cord. They’re located in the dura mater — a thick membrane that surrounds the spinal cord. Here are some common types:

• Ependymoma: An ependymoma tumor begins in the ependymal cells — glial cells that line the fluid-filled spaces in the spinal cord. Ependymal cells help move fluid through the spinal canal.
• Astrocytoma: An astrocytoma tumor forms in the astrocytes. These cells in the spinal cord help nerve cells function properly.
• Hemangioblastoma: Hemangioblastoma tumors develop in the blood vessels of the spinal cord, brain and retina. They can grow in any area of the spinal cord.
• Lipoma: A lipoma is a benign rubbery, slow-growing lump of fat tissue. It usually situates in the middle of the back between skin and muscle, pressing against the spinal cord. Lipoma tumors tend to run in families, suggesting that genetic factors play a role in their development.

Intradural-Extramedullary Tumors

These tumors emerge within the outermost spinal cord layer, or the dural sheath. As intradural-extramedullary tumors expand, they compress the nerves in and around the spinal cord. Some common types are:

• Meningioma: A meningioma tumor stems from the meninges — thin membranes encompassing the spinal cord and brain. It typically occurs in the middle or upper spine. Women are about twice as likely to develop noncancerous meningioma as men.
• Neurofibroma: Neurofibromas are benign tumors that grow along the nerve cells. They often occur in individuals with neurofibromatosis — a rare, inherited condition causing tumors throughout the skin and central nervous system.
• Schwannoma: Schwannomas are rare tumors that derive from Schwann cells, which support and insulate the nerve cells of the nervous system. They are usually situated within the dura on the outside of the spinal cord. Most Schwannoma tumors are benign, but they occasionally become cancerous.
• Myxopapillary ependymoma: Myxopapillary ependymoma (MEPN) is a slow-growing ependymoma that originates in the tissue surrounding the spinal cord. It generally occurs in the lower spinal column and often remains benign.

Diagnosis of Spinal Tumors

A spinal tumor diagnosis typically begins with a comprehensive medical examination to assess the patient’s symptoms. While some spinal lesions don’t include symptoms, most cause back pain that progresses with continued tumor growth. 

Other hindrances like numbness or weakness may accompany the pain. Spinal tumor symptoms can vary depending on the location and whether or not it’s cancerous. Some common indicators of a spinal tumor include:

• Back pain that radiates to other areas of the body
• Bowel or bladder dysfunction
• Loss of sensation
• Muscle weakness throughout the body
• Difficulties with walking or mobility

Your doctor can perform diagnostic imaging to identify the tumor’s size, precise location and spinal impact. Imaging also helps them determine your vertebrae’s overall health and stability. 

The information from an imaging test can help your doctor pursue an appropriate treatment route. Below are some common imaging technologies for spinal tumors.

MRI

A magnetic resonance imaging (MRI) exam uses powerful radio waves to generate three-dimensional images of the spinal cord, nerve roots and tumor. It tends to be the most reliable and preferred diagnostic method for spine tumors. 

Even if you experience minimal pain or symptoms, an MRI can detect spinal cord compression. A doctor may inject a contrast agent into your hand or forearm to highlight certain structures and tissues.

CT Scan

A computed tomography (CT) scan uses a series of x-ray views to produce detailed spine images, pinpoint the tumor’s size and location, and assess bone health and quality. A contrast dye injection may be used to enhance spinal canal or cord visibility. 

A CT scan can help determine the tumor’s severity and whether it has spread. However, it’s a less common technique for spinal growths than MRI scans.

Biopsy

After obtaining the imaging test results and confirming the tumor’s presence, the next step is determining whether it is malignant or benign. Your doctor performs a biopsy procedure, extracting a small tissue sample. This sample is then sent to a laboratory and examined under a microscope.

After assessing the findings of the sample, your medical team can determine the right treatment plan. This may include surgical or nonsurgical intervention, depending on the tumor’s severity.

Treatment Options for Spine Tumors

Once your medical provider has reached a diagnosis, they’ll tailor a treatment plan to your unique needs and circumstances. Some common spinal tumor treatments include:

1. Monitoring

For small spinal tumors that aren’t growing, showing symptoms, spreading or pressing on surrounding tissues, careful observation will usually suffice. Your doctor might recommend periodic MRI or CT scans to monitor the tumor.

2. Chemo or Radiation

Radiation therapy is typically used to:

• Eliminate tumor remnants after surgery
• Treat tumors where surgery is too risky, such as a tumor connected to surrounding tissue or a preexisting medical condition
• Treat inoperable tumors

This therapy uses concentrated radiation beams to disrupt tumor cell function and shrink the growth. Unless surgery isn’t a feasible option, radiation isn’t normally used on its own. It’s often a supplement to surgery to ensure total elimination of tumor cells.

Conversely, chemotherapy uses medications to destroy cancer cells or stunt their growth. Your doctor can determine whether chemotherapy is right for you, either in conjunction with radiation or on its own.

3. Surgery 

Doctors usually pursue spinal surgery if a patient exhibits metastasis — secondary malignant growth — and a life expectancy of 12 weeks or longer. Different spinal surgery procedures include:

• Decompression: This operation completely or partially removes the tumor.
• Embolization: Embolization slows or cuts off the tumor’s blood supply, which causes it to shrink.
• Vertebroplasty or kyphoplasty: These minimally invasive procedures stabilize a fractured vertebra and help alleviate pain.

During the procedure, your doctor can monitor spinal cord function and nerves to avoid injuring them. In some cases, they may use high-frequency sound waves to break up the tumor and remove fragments.

Remember that not all tumors can be fully removed with surgery, even with the latest technological advancements. If the tumor can’t be completely removed, radiation therapy, chemo or both may follow surgery. 

Depending on the procedure, spinal surgery recovery may take a couple of weeks or longer. Your doctor will guide you through the recovery process and offer advice to accelerate healing.

Contact New York Spine Institute for Spinal Tumor Treatment

If you think you may have a spinal tumor, contact New York Spine Institute for help. Our range of services includes diagnostic imaging, complex and minimally invasive spine surgeries, and more. We can customize a treatment plan to your unique situation, helping you start your recovery journey. Schedule an appointment to begin treatment today.