Types of Spinal Tumors

There are three common types of spinal tumors: vertebral column, intradural-extramedullary and intramedullary.

Vertebral Column Tumors – The 33 vertebrae that fit together to form a tough, yet flexible column that supports the back through a full range of motion is referred to as the vertebral column. And the tumors that form here are called vertebral column tumors, which can be broken down into two sub-categories:

Primary Tumors – Typically occurring in younger adults, primary spinal tumors occur in the vertebral column and originate from the bone or disc components of the spine. Most primary tumors are rare in nature and develop very slowly.

Metastatic Tumors – In most cases, spinal tumors are the result of cancer in another part of the body metastasizing (spreading) to the spine. In women, spine tumors generally spread from cancer originating from the breast or lung. In comparison, men usually develop spinal tumors from cancer that has spread from the prostate or lung.

Intradural-Extramedullary Tumors – Intradural-extramedullary tumors grow within the spinal canal under the dura, the outermost membrane that covers and protects the spinal cord. Though these tumors are benign and grow slowly, they may cause pain and weakness.

There are two common types of Intradural-extramedullary tumors: meningiomas and nerve sheath.

• Meningioma tumors: More common in middle age and elderly women, these tumors occur in the membranes that surround the spinal cord. Meningiomas are typically benign but may be malignant in some cases.
• Nerve sheath tumors (schwannomas and neurofibromas): Nerve sheath tumors arise from the nerve roots that stem from the spinal canal. These tumors are noncancerous in most cases.

Intramedullary Tumors – Intramedullary tumors grow from within the spinal cord or inside the individual nerves. The tumors originate from the glial cells that provide insulation and physical support for the nervous system and occur most often in the cervical (neck) spine.

Treatments for Spinal Tumors

While treatments for spinal tumors will vary depending on a patient’s individual needs, our practice offers non-surgical and surgical options, including chemotherapy, radiation, laminectomy and anterior vertebral body replacement.

Chemotherapy and Radiation – Chemotherapy and radiation may be used:

• To eliminate what remains of a tumor following surgery.
• To treat inoperable tumors.
• As an alternative treatment for tumors or pain where surgery poses too great of a risk.
• As the first line of treatment for metastatic tumors.

In some cases, chemotherapy and radiation treatment may be modified to prevent damage to surrounding healthy tissue and improve the effectiveness of treatment.

Laminectomy and Instrumentation – A laminectomy, also known as decompression surgery, is a surgical procedure that relieves pressure on the spinal nerves or cord. This is accomplished by removing the lamina, the back portion of the vertebrae that covers the spinal canal.

During the procedure, an incision is made in the back and the muscles are pulled aside for access to the spine. Small surgical instruments are then used to remove the lamina and tumor.

Once the tumor is removed, screws and rods are put in place to provide stability to the spine and decrease the need for a post-operative brace. Following the procedure, patients should avoid heavy lifting and sudden twisting or bending for six to 12 weeks.

Anterior Vertebral Body Replacement – Anterior vertebral body replacement is performed when a spinal tumor has spread to the front of the spine and fractured vertebrae, causing pressure on the spinal cord.

During the procedure, an incision is made on the side of the chest and surgical instruments are used to remove the diseased vertebrae and associated disc material. A metal cage filled with bone graft material is then placed in the empty space to aid in fusing the remaining vertebrae together and to ensure spinal stability. In addition, screws are inserted into the remaining healthy vertebrae and connected to rods for further stability.

Complete fusion of the vertebrae typically takes three to six months. During that time, patients are asked to avoid heavy lifting and unnecessary motion.