What is Spinal Tumour?

A spinal tumour is a growth that develops within your spinal canal or within the bones of your spine. A spinal cord tumour, also called an intradural tumour, is a spinal tumour that that begins within the spinal cord or the covering of the spinal cord (dura). A tumour that affects the bones of the spine (vertebrae) is called a vertebral tumour.
Spinal cord tumours may be classified as one of three different types depending on where they occur relative to the protective membranes of the spinal cord.
These are the main types of intradural tumours:
  • Intramedullary tumoursbegin in the cells within the spinal cord itself, such as gliomas, astrocytomas or ependymomas.
  • Extra medullary tumours grow in either the membrane surrounding the spinal cord or the nerve roots that reach out from the spinal cord. Although they don’t begin within the spinal cord itself, these types of tumours may affect spinal cord function by causing spinal cord compression and other problems. Examples of extramedullary tumors that can affect the spinal cord include meningiomas, neurofibromas, schwannomas and nerve sheath tumours.
Spinal tumours sometimes might be overlooked because they’re not common and their symptoms resemble those of more common conditions. For that reason, it’s especially important that your doctor know your complete medical history and perform both general physical and neurological exams.
If your doctor suspects a spinal tumour, these tests can help confirm the diagnosis and pinpoint the tumour’s location:
  • Spinal magnetic resonance imaging (MRI). MRI uses a powerful magnetic field and radio waves to produce accurate images of your spine, spinal cord and nerves. MRI is usually the preferred test to diagnose tumours of the spinal cord and surrounding tissues. A contrast agent that helps highlight certain tissues and structures may be injected into a vein in your hand or forearm during the test. Some people may feel claustrophobic inside the MRI scanner or find the loud thumping sound it makes disturbing. But you’re usually given earplugs to help with the noise, and some scanners are equipped with televisions or headphones. If you’re very anxious, ask about a mild sedative to help calm you. In certain situations, a general anaesthetic may be necessary.
  • Computerized tomography (CT). This test uses a narrow beam of radiation to produce detailed images of your spine. Sometimes it’s combined with an injected contrast dye to make abnormal changes in the spinal canal or spinal cord easier to see. A CT scan is only rarely used to help diagnose spinal tumours.
  • Biopsy. The only way to determine the exact type of a spinal tumour is to examine a small tissue sample (biopsy) under a microscope. The biopsy results will help determine treatment options.
Ideally, the goal of spinal tumours treatment is to eliminate the tumours completely, but this goal may be complicated by the risk of permanent damage to the spinal cord and surrounding nerves. Doctors also must take into account your age and overall health. The type of tumours and whether it arises from the structures of the spine or spinal canal or has spread to your spine from elsewhere in your body also must be considered in determining a treatment plan.
Treatment options for most spinal tumours include:
  • Some spinal tumours may be discovered before they cause symptoms — often when you’re being evaluated for another condition. If small tumours aren’t growing or pressing on surrounding tissues, watching them carefully may be all that’s needed.
During observation, your doctor will likely recommend periodic CT or MRI scans at an appropriate interval to monitor the tumours.
  • This is often the treatment of choice for tumours that can be removed with an acceptable risk of spinal cord or nerve injury damage. Newer techniques and instruments allow neurosurgeons to reach tumours that were once considered inaccessible. The high-powered microscopes used in microsurgery make it easier to distinguish tumours from healthy tissue. Doctors also can monitor the function of the spinal cord and other important nerves during surgery, thus minimizing the chance of injuring them. In some instances, very high-frequency sound waves might be used during surgery to break up tumours and remove the fragments. But even with the latest technological advances in surgery, not all tumours can be totally removed. When the tumours can’t be removed completely, surgery may be followed by radiation therapy or chemotherapy or both. Recovery from spinal surgery may take weeks or longer, depending on the procedure. You may experience a temporary loss of sensation or other complications, including bleeding and damage to nerve tissue.
  • Radiation therapy.This may be used to eliminate the remnants of tumours that remain after surgery, to treat inoperable tumours or to treat those tumours where surgery is too risky. Medications may help ease some of the side effects of radiation, such as nausea and vomiting. Sometimes, your radiation therapy regimen may be adjusted to help minimize the amount of healthy tissue that’s damaged and to make the treatment more effective. Modifications may range from simply changing the dosage of radiation to using sophisticated techniques such as 3-D conformal radiation therapy.
  • A standard treatment for many types of cancer, chemotherapy uses medications to destroy cancer cells or stop them from growing. Your doctor can determine whether chemotherapy might be beneficial for you, either alone or in combination with radiation therapy. Side effects may include fatigue, nausea, vomiting, increased risk of infection and hair loss.
  • Other drugs.Because surgery and radiation therapy as well as tumours themselves can cause inflammation inside the spinal cord, doctors sometimes prescribe corticosteroids to reduce the swelling, either after surgery or during radiation treatments.
Dr. Vivek M. Agrawal has been associated with VIMS HOSPITAL as chief consultant Neurosurgeon/ Spine surgeon since its beginning. Till JULY 2022, he has performed more that 700 Brain and spine surgeries and seen more than 5500 OPD patients. He has been doing regular CMEs and free Camps for the patients benefit.
He is doing all kinds of brain and spine related surgeries including complex vascular surgeries, endoscopic surgeries, minimally invasive spine surgeries