Treatments for spinal tumors

If any tumor is found in the spine (and there is no other known cancer), a complete examination of all common organs where cancer develops is usually warranted. Evaluation may include:

• Complete medical history

• Complete physical examination

• Complete neurological examination

• Radiographic studies of the spine, chest and GI system to screen for tumors

• MRI and CAT scans to examine the spine

Treatments for each common type of spinal tumor may include:

1. Vertebral column tumors

Because most of these tumors arise from advanced cancer from another organ, the goal of spinal treatment is usually to:

• Control the severe pain that often occurs with these tumors (e.g. by removing pressure on the nerve roots)
• Preserve neurological function (e.g. by removing the pressure on the spinal cord)
• Fix structural instability in the spine (e.g. by reconstructing the unstable spine with a fusion)

2. Intradural-Extramedullary and Intramedullary Tumors

These types of tumors are usually surgically removed. The goal of treatment is usually to:

• Totally remove the tumor
• Preserve neurological function

The spinal cord and nerves are highly sensitive and avoiding damage to these structures is a critical part of surgery. Monitoring techniques may be used throughout the surgery to determine the function of the spinal cord as the tumors are being removed (e.g. SSEP).

If the tumor cannot be completely removed (e.g. if it adheres to many spinal nerves), post-operative radiation therapy may improve outcome in some cases. If the tumor is metastatic, chemotherapy may also be helpful.

Following the surgery, it may take some time for the nerves to fully heal. Usually rehabilitation and time significantly helps improve a patient’s neurological function.

By: John H. Schneider, MD
April 2000