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How We Handle Spinal Tumors

How We Handle Spinal Tumors

Spinal tumors are abnormal growths that develop in the spinal canal or inside the vertebrae, the bony structures of the spine.

The most common primary spine tumor — a tumor that originates in the bones of the spine — is vertebral hemangiomas. These tumors are benign (non-cancerous) and rarely cause any symptoms, like pain.

The spinal column, though, is the most common area for bone metastasis (cancer that originates elsewhere and spreads). Anywhere from 30%-70% of cancer patients experience metastasis into their spine. In men, lung cancer is the most common source of metastasis, and in women, it’s breast cancer. In all cases, prompt diagnosis and treatment of the primary malignancy is essential for overall recovery.

At Center for Neurosurgery Las Vegas, board-certified and fellowship-trained neurosurgeon Dr. Scott Glickman and his staff understand that all spinal tumors, benign or cancerous, require treatment, and they have the expertise and experience to accurately diagnose your problem and treat you successfully. Here’s what they want you to know about spinal tumors and how they handle them.

Classifying spinal tumors

Spinal tumors can be classified in two ways. The first is in which of the spine’s four regions — cervical, thoracic, lumbar, and sacrum — they occur.

The second way is by their location within the spine, and there are three subcategories:

1. Intradural extramedullary

These tumors grow inside the thin covering around the spinal cord (the dura), but outside the spinal cord itself. This category represents about 40% of cases. The most common of these develop in the arachnoid membrane (meningiomas), in the nerve roots extending from the spinal cord (schwannomas and neurofibromas), or at the base of the spinal cord (filum terminale ependymomas).

Meningiomas are often benign, but they can be difficult to remove and often grow back. Nerve root tumors are also usually benign, although neurofibromas tend to become malignant over time. Ependymomas can grow quite large, and the delicate neural structures at the base of the spinal cord may make their removal difficult.

2. Intramedullary

These tumors grow inside the spinal cord and usually form from glial or ependymal cells, two types of nerve support cells. This category represents about 5% of cases. Astrocytomas are most common in the thoracic (chest) region, followed by the cervical (neck) region. Ependymomas are most common at the bottom of the spinal cord, followed by the cervical region. They’re often benign, but, as mentioned, they can prove difficult to remove.

3. Extradural

These tumors grow outside the dura and account for about 55% of cases. They’re most often  attributed to metastatic cancer or, occasionally, schwannomas from the cells covering the nerve roots.

Symptoms of a spinal tumor

Unlike hemangiomas, which typically display no symptoms, most spinal tumors cause a variety of symptoms. Topping the list is pain. If you experience continuous pain in your middle or lower back and can rule out stress, physical activity, or an injury, it may indicate you have a spinal tumor. You’ll probably notice the pain most when you’re active and just after you lie down.

Pain from a spinal tumor doesn’t necessarily remain localized; it can radiate from the back into the feet, legs, arms, or hips. Traditional back pain treatments like massage or physical therapy are not only ineffective, but they also make your pain worse.

Additional symptoms of a spinal tumor include:

Your exact symptoms will vary depending on the location, size, and type of tumor you have.

How we handle spinal tumors

Your exact treatment depends on your diagnosis and prognosis.

For patients with benign spinal tumors like a hemangioma, Dr. Glickman usually starts with a wait-and-see approach. Before considering surgery, he monitors the tumor with regular MRI scans. If the tumor is particularly large, is pressing on nerves, and is causing other health issues, he might then recommend surgery to improve your quality of life.

Primary spinal tumors can often be removed through complete en bloc resection, which removes the tumor, the contiguous lymph nodes, and everything in between, meaning it’s a potential cure.

The majority of spinal tumors Dr. Glickman sees, though, are due to advanced-stage, metastasized  cancer. In these cases, he works with your oncologist to control the crippling pain. He might perform decompression surgery to relieve impingement on the nerves and spinal cord, and/or spinal fusion to prevent the collapse of the spinal column.

If you’re experiencing any of the symptoms of a spinal tumor, time is of the essence. Give Center for Neurosurgery Las Vegas a call at 702-929-8242 to schedule a consultation with Dr. Glickman. You can also text us at 725-210-0057, or book your appointment online.

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