Vertebral Tumor

Providing Treatment for Back and Spine Cancers

Vertebral tumors are sometimes overlooked, especially because their primary symptom – back pain – resembles many other, more common conditions. Because the spinal cord is so vital to the human body, it is important to diagnose and treat vertebral tumors as soon as possible. Our board-certified physicians at the Back & Spine Center of The Department of Neurosurgery at Rutgers Health and RWJBarnabas Health are dedicated to providing the best care for patients suffering from vertebral tumors. Our spinal care specialists include neurosurgeons and orthopedic surgeons who work together in a multidisciplinary team approach. Our neurosurgeons are at the forefront of spinal surgical care and utilize state-of-the-art, minimally invasive techniques to create customized treatment plans for our patients.

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What Is a Vertebral Tumor?

Vertebral tumors affect one vertebra or multiple vertebrae. These bones make up the spinal column, stacked on top of one another, enclosing and protecting the spinal cord. A vertebral tumor may also involve the spinal cord, although those are referred to as spinal cord tumors. One complication of untreated vertebral tumors is a permanent loss of movement or sensation below the site of the tumor.

Most vertebral tumors are cancerous and have metastasized (spread) from the original tumor site to the spinal column. The most common cancers to spread to the vertebrae are prostate, breast, lung, and kidney. However, some vertebral tumors do originate in the vertebrae (these are called primary tumors), such as chordomas. Primary tumors of the vertebra are very rare.

Even benign (noncancerous) vertebral tumors can be life-threatening, because they can impede neurological function by pressing against the spinal cord or other nerves in the local area. A benign tumor can even cause spinal instability, increase your risk of fractures, and cause intense pain.

Vertebral Tumor Types

Vertebral tumors are classified by their location in the spinal column. There are 3 main sections of the spine. The topmost section located in the neck is called the cervical spine; the middle section in the upper/mid-back is called the thoracic spine; the lower back is the lumbar spine; and the lowest portion of the spine located below the small of the back, between the hips, is called the sacral spine (the tailbone).

Spinal tumors are also classified by their location inside or outside the dura matter – the protective covering over the spinal cord, and whether they are located inside or outside the “medulla” – the substance of the spinal cord.

Types of vertebral tumor classifications:

  • Extradural tumors are located outside the dura mater, outside of the spinal cord. Tumors in this location are usually metastatic tumors (tumors that have spread from their original location through the bloodstream).
  • Intradural-extramedullary tumors are located inside the dura and outside the spinal cord (outside the medulla and inside of the dura). The most common tumors in this area are called meningiomas, which are usually benign.
  • Intramedullary tumors (meaning inside the medulla) are those which arise in the substance of the spinal cord itself, inside the dura. The most common tumors found in this area are astrocytomas, ependymomas, and hemangioblastomas.

Symptoms of Vertebral Tumors

Depending on the tumor type, location, and aggressiveness, symptoms vary. Symptoms also change as the tumor grows. The most common signs of a vertebral tumor include:

  • Back pain in one spot that gets worse at night
  • Loss of sensation in the limbs
  • Muscle weakness
  • Incontinence
  • Difficulty walking
  • Frequent falling
  • Paralysis in different body areas

Vertebral Tumor Diagnosis

A diagnosis of a vertebral tumor is confirmed by the following:

  • Spinal magnetic resonance imaging (MRI): This imaging test is the preferred test for diagnosing spinal tumors. It produces accurate images of the structures of the spine, including the spinal cord and nerves.
  • Computerized tomography (CT) scan: This is another type of imaging test that produces images of the spine and is often used in combination with an MRI.
  • Biopsy: The only way to definitively diagnose the type of vertebral tumor a patient has is to examine a tissue sample under a microscope. A fine needle is used to extract a small amount of tissue, and then the tissue is examined under a microscope by a pathologist.

Vertebral Tumor Treatment

The goal of treatment is to completely get rid of the tumor, but this might be impossible, due to the risk of permanent nerve damage to the spinal cord. Treatment also depends on whether the tumor is primary or if it has metastasized to the vertebrae. Some tumors may be simply monitored if they aren’t growing or pressing on surrounding tissues.

The most common treatment options for vertebral tumors include:

  • Surgery: If the tumor can be removed without risking injury to the spinal cord or nerves, surgery is the preferred method for removing a vertebral tumor.
  • Radiation therapy: If a tumor still has inoperable remnants after surgery, radiation therapy may be used to eliminate them. It can also significantly reduce spinal pain, especially if surgery is too risky.
  • Stereotactic radiosurgery (SRS): This treatment delivers a high dose of radiation with laser precision to eliminate the tumor. Common types of SRS include Gamma Knife® and CyberKnife®.
  • Chemotherapy: Cancerous vertebral tumors may be treated with chemotherapy, a cancer-killing drug often administered intravenously.

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