Spinal Cord Tumor: What is it, Causes, Symptoms and Treatment

Tumors form as a result of the uncontrolled reproduction and growth of some cells in any tissue or organ of the body.

Tumors form as a result of the uncontrolled reproduction and growth of some cells in any tissue or organ of the body. It is not possible to stop or slow down this proliferation and growth with the autocontrol pathways that function in the body. However, these tumors occurring in the body may not always be malignant. There are also benign tumors. The concepts of tumor and cancer are concepts that are often confused with each other in daily life, but actually malignant tumors are called cancer. Spinal tumors have a share of 20% among Central Nervous System tumors. Although its frequency varies in societies, it can be seen at a rate of 2-10/100,000.

What is the Function of the Spinal Cord?

The spinal cord provides communication between the brain and other organs with the help of nerves and is located in a thick membrane, just like the brain. It extends from the skull to the waist within the bone called vertebra. While the signals coming from the brain are transmitted to the arms and legs or other organs, data from different organs are also transmitted to the brain in this way. Due to these functions, patients may become paralyzed in case of any tumor that may occur in the spinal cord.

What is a Spinal Cord Tumor?

Spinal cord tumors are tumors that occur in the bones, nerves or other soft tissues that make up the spine and spinal cord. It can occur in two ways: primary and metastatic (spread of another cancer).

While primary tumors occur due to the actual cells that form the structure of the spine and spinal cord, metastatic tumors are a class of tumors that form in the spinal cord when a tumor that has previously formed in different parts of the body cannot be controlled and spreads to the spine.

Apart from the membrane layer of the spinal cord, tumors can also occur in the area between this membrane and the spinal cord and in the inner regions of the spinal cord. The cause of the majority of tumors outside the spinal cord is metastasis of tumors that have formed in different parts of the body. Although it is not a definitive situation, tumors arising from the inside of the spinal cord and its membranes or the nerve itself are benign tumors.

It is divided into 3 separate classes according to the location of the tumor. It is divided into extradural (located outside the spinal membrane), intradural extramedullary (within the spinal membrane, outside the nerves) and intradural intramedullary (within the spinal membrane, inside/adherent to the nerves). It is the most common extradural tumor.

Metastatic tumors are quite common in men between the ages of 45-65. Early diagnosis has a very important place in spinal cord tumor treatments, as in other diseases.

What are the Symptoms of Spinal Cord Tumor?

As with any disease, the duration of symptoms may vary from person to person, depending on the location of the tumor and its growth/reproduction rate.

• If the tumor is not diagnosed and treated in time, it grows and causes pressure on the spinal cord. Pain may also be felt in the back after pressure on the spinal cord.

• Problems occur depending on the damage to the nerve that the tumor puts pressure on, depending on its location. Different findings occur in the neck, back and waist.

• Pains that can be seen in the back as well as in the neck and waist areas and are severe enough to not go away even if you rest (Pains increase with factors such as coughing, straining, and sneezing that increase intracranial pressure in the initial stage and increase with rest, but as the condition progresses, it becomes impossible to relieve with rest.)

• Tingling and numbness in certain parts of the body (For example, if the tumor is in the neck area, numbness may occur in the arms and legs; if it is in the back and waist area, numbness may occur only in the legs.)

• Feeling of coldness in the body

• Weakening and muscle wasting in different parts of the body, especially in the arms or legs

• Difficulty in walking due to numbness and muscle weakness

• Incontinence, incontinence, or straining to urinate or defecate due to loss of control of the intestines or bladder

• Curved appearance (scoliosis-kyphosis) due to tumor in the spine

• Impairment in sexual functions, which can be seen when treatment is delayed and the disease reaches advanced stages.

• There are serious symptoms that can lead to paralysis (paralysis in the arms and legs if it is in the neck, paralysis in the legs if it is in the back or waist).

What are the Causes of Spinal Cord Tumor?

The general causes of tumor formation are not fully known. These factors include genetic factors, some chemical factors, long-term exposure to radiation and infection with various viruses. Another important cause of spinal cord tumor is that malignant tumors seen in different organs metastasize and spread here.

How is Spinal Cord Tumor Diagnosed?

The patient’s complaints and examination are important. Afterwards, the location of the tumor is determined using imaging techniques. PET CT is especially important in patients with metastases to the spine who are being followed up for cancer. An MRI of the entire spine or the part of the spine where pain is felt particularly strongly may be requested. Computed tomography is required, especially for bone tumors. How healthy the nerves are working in these patients can be supported by electrophysiological studies such as EMG and SEP.

Severe pain in the back, neck and waist areas, which are seen as symptoms, should be taken seriously so that the person can apply to various health institutions for diagnosis. These pains are severe enough to cause patients to wake up at night.

How is Spinal Cord Tumor Treated?

Tumors occurring in the spinal cord are generally benign, but the opposite is also possible. How spinal cord treatment is performed varies depending on the location of the tumor, the type of tumor, the symptoms that occur in the patient due to the tumor, and the personal characteristics of the patient. As with every disease, early diagnosis is of great importance in this disease.

Treatment method with surgical operation:

“Microsurgical” treatment to be performed in the hybrid operating room increases the surgical success of these patients. Today, with this technique, surgeries can be performed successfully on patients who could not undergo surgery in the past or who had very severe complications (such as paralysis) after surgery.

In the treatment of benign tumors, complete microsurgical removal of the tumor results in cure.

There are several surgical options for malignant tumors. After discussion at the neuro-oncology council, the best treatment option is offered to the patient. These patients can be given radiotherapy and chemotherapy according to the pathology results after microsurgery performed in the hybrid operating room.

Depending on the patient’s condition and spinal involvement, surgeries such as separation (simple surgery), stabilization surgery with screws, and bone cement called vertebroplasty may be added along with microsurgery.

We clinically perform microsurgery with a minimally invasive method (opening a small window in the bone that causes minimal damage to tissue and bone). During surgery, we use many technological devices in the hybrid operating room, such as a fluorescein-enabled microscope (a special microscope that stains the tumor), neuromonitorization (technology that allows the nerves going to the arms and legs to be monitored during surgery), O arm–CT (tomography device used during surgery) and neuronavigation.

Radiation Therapy (radiotherapy):

It is a treatment method that aims to reduce pain or control the spread. With Cyberknife technology, irradiations that could not be done in the past can be irradiated without damaging the nervous system. Radiosurgery can be performed after surgical operations or on its own. In some cases, tumor treatment can be achieved by giving the patient a combination of drug therapy and radiation therapy.

Drug treatment (chemotherapy):

The choice of medication used in this treatment is chosen by the specialist physician according to the tumor type and the possibility of spread. It can also be applied after surgical operations or radiation therapy. Sometimes, the specialist physician may start drug treatment directly at the first stage, taking into account the condition of the tumor.

Physiotheraphy:

It is recommended in the post-surgical period in order to make it easier for the patient to regain his/her previous muscle strength and return to his/her old life. It is a process in which physiotherapists and doctors take part together. It may take 3 or 6 months; in general, periodic application is considered appropriate.

Pain treatment:

Tumors can sometimes cause very serious pain. Very rarely, pre- and post-operative pain treatment may be required.

Early diagnosis of the disease is very important for treatment. For this reason, severe pain felt in the back, neck or waist area should not be ignored. If these symptoms are noticed, do not forget to consult the nearest health institution.