Spinal cord tumors are masses of abnormal cells that grow in the spinal cord, between its protective sheaths, or on the surface of the sheath that covers the spinal cord. The spinal cord, which lies protected inside the spine, contains bundles of nerves that transmit messages between the brain and the nerves throughout the body. A tumor on or near the spinal cord can disrupt this communication, impair function and seriously threaten health.

About 10,000 people in the United States develop spinal cord tumors each year. Most noncancerous tumors develop within the spinal cord rather than spreading from other parts of the body. These are called primary tumors, and they usually are noncancerous (benign). Primary spinal cord cancers rarely spread to other parts of the body. Spinal cord cancers have been a focus of scientific investigation because their unique qualities may bring about new ways of cancer prevention or treatment.

Most cancerous spinal cord tumors are secondary, meaning they spread from a cancer at another site of the body. One in every four people whose cancer has spread throughout the body has had it spread to the brain or spinal cord. These secondary tumors most frequently result from lung, prostate or breast cancer.

Spinal cord tumors can affect people of all ages, but are seen most commonly in young and middle-aged adults. While some benign tumors can occur more often in certain families, the cause of primary spinal cord tumors is unknown. Possible causes include defective genes, viruses and exposure to chemicals.

Doctors divide spinal cord tumors into three major groups based on their location:

  • Extradural tumors grow outside of the dura mater (the membrane that protects the spinal cord) and are usually in the bones surrounding the spinal cord. Most spinal cord tumors are extradural.
  • Intradural-extramedullary tumors grow outside of the spinal cord and within the dura mater.
  • Intramedullary tumors grow inside the spinal cord itself.

What are the symptoms?

Spinal cord tumors generally develop slowly and get worse over time. They can cause many symptoms depending upon where they are located. Symptoms surface as the tumor presses on the spinal cord. Tumors also may restrict the flow of blood to the spinal cord. Common symptoms include constant and aching back pain, sensory changes — which can take the form of numbness, tingling, decreased sensitivity to temperature or cold sensations and motor problems — and muscle-related symptoms, such as progressive muscle weakness or loss of control over the bowel or bladder. The part of the body affected by the symptoms will vary depending on the tumor’s location on the spinal cord. In general, symptoms occur in parts of the body that are at the same level as or lower than the tumor.

How is it diagnosed?

If a patient has any of the symptoms of a spinal cord tumor, the doctor will review his or her medical history for other conditions that may cause similar symptoms. The physical exam will include a standard neurological examination, which checks eye movement, eye reflexes and pupil reaction, reflexes, hearing, sensation, strength, balance and coordination.

If the doctor suspects a patient to have a spinal tumor, he or she may recommend x-rays of the spine and other diagnostic tests, including:

Computed tomography (CT) can determine the location of the tumor on the spinal cord and can help detect swelling, bleeding and other associated conditions. The technique creates a cross-sectional view of the body’s tissue and structure using a computer and an X-ray camera that rotates around the body. A dye sometimes is injected into a vein before the scan to help show differences between tissues, which makes it easier to see the tumor.
Magnetic Resonance Imaging (MRI) gives a picture of the spinal cord using a powerful magnet, a radio wave transmitter and a computer. This technique can provide better pictures of tumors near bone than computed tomography.
In this specialized X-ray technique, a dye that absorbs X-rays is injected into the spinal cord. The dye outlines the spinal cord, but will not pass through the tumor, creating an image with a dark or narrowed area that indicates the tumor’s location. Myelograms are done occasionally because MRI provides similar information and does not require a spinal injection.
This procedure removes a sample of cerebrospinal fluid (a clear, colorless bodily fluid found in the brain and spine), which is tested for abnormal cells that may suggest the presence of a spinal cord tumor.
A sample of the tumor may be removed and examined under a microscope to confirm the diagnosis and rule out other conditions. However, it can be difficult to obtain a biopsy of a spinal cord tumor without damaging the spinal cord so careful planning and imaging (such as MRI or CT scan or both) are important. In many cases (especially when a person is known to have cancer already), treatment of the spinal cord tumor may not require a biopsy.

What are the treatment options?

Surgery is often recommended for noncancerous and cancerous primary spinal cord tumors and is usually successful for tumors located outside the spinal cord. Some tumors may be impossible to remove without significantly damaging the spinal cord. In those cases, radiation therapy may be used to slow the tumor’s growth. Surgical removal of surrounding vertebrae can also help to relieve pain and other symptoms by reducing pressure on the spinal nerves.

Chemotherapy may be recommended for certain types of tumors, usually after surgical treatment.
For secondary tumors, the treatment will depend upon the type of cancer that has spread to the spinal cord. Radiation is regarded as a primary treatment for secondary cancer compressing the spinal cord. With radiation therapy, care must be taken to limit possible damage to surrounding normal spinal tissue, because such damage can continue to worsen and be irreversible. The spinal cord is even more sensitive to the effects of radiation than brain tissue.

With all types of spinal cord tumors, corticosteroid drugs also may reduce spinal cord swelling. In addition, physical therapy may be needed to help a person regain muscle control and strength after radiation or surgery.