Spinal Tumors: Understanding the Symptoms and Treatment

The spine, a vital component of our skeletal system, plays an important role in our overall well-being. Tumors in this delicate region pose unique challenges that require understanding, awareness, and effective treatment.

Spinal tumors can significantly impact an individual's quality of life. But with globally renowned medical facilities and skilled healthcare professionals, countries like India, Malaysia, Turkey, Thailand, Germany, UAE etc., offer a multidisciplinary approach, ensuring patients receive personalized care. 

These countries boast state-of-the-art hospitals with advanced technology for accurate diagnosis and innovative treatment options.

The cost of spine tumor surgery In India usually ranges between USD 4500 to USD 8000, while it costs USD 4950 to USD 6050 in Turkey and USD 8100 to USD 9900 in Malaysia.

Cancer treatment has transformed over the past 40 years, with medical oncologists, radiation oncologists, and surgeons working together to prolong survival and minimize treatment-related morbidity. As technology has improved, the medical field has been able to evaluate the risks and benefits of surgical procedures.

What are Spinal Tumors?

An abnormal mass of cells in or around the spinal cord/column is called a spinal tumor.

Spinal tumors can be located:

• Intramedullary - Inside the spinal cord 
• Intradural-extramedullary - In the tissues covering (meninges) the spinal cord 
• Extradural - In between the meninges and bones of the spine 
• In the bony vertebrae of the spine

Spinal tumors can be noncancerous (benign) or cancerous (malignant). As the tumor grows, it may cause damage to various tissues in the spinal column. Tumors that form on the spine or spinal cord are classified as either primary or metastatic. 

Primary tumors develop directly in the spine, while metastatic tumors result from cancer spreading to the spine from another body part. Primary tumors are less common than secondary tumors.

Did you know 90% of spine tumors result from metastatic cancer originating from different body parts?

Watch the video below to learn about Dipa Mandal from Bangladesh who visited India for Spine Surgery as she was diagnosed with Lumbar Disc Herniation.

What are the Symptoms of Spinal Tumors?

Regardless of the location, spinal cord tumor causes the following symptoms:

• Numbness
• Weakness sometimes causes a lack of coordination in the arms and legs
• Stiff back or neck
• Difficulty in controlling urine and bowel movement
• Difficulty in walking causing falls
• Reduced sensitivity to thermal stimulus
• Scoliosis or other spinal deformity, result of a large and/or destructive tumor
• Muscle twitches or spasms
• Paralysis occurs in varying degrees and different body parts

What are the Different Types of Spinal Tumors?

Spinal tumors can be categorized in many ways, including:

• Cervical, thoracic, lumbar, or sacrum - Where the tumor is located along your spine
• Intradural-extramedullary, intramedullary, or extradural - Where the tumor is located within your spinal column 
• Secondary spinal tumor - If the tumor began in your spine (primary spinal tumor) or results from metastasis from cancer in another area of your body 
• If the tumor is benign or malignant 

Which Types of Cancer Spread (Metastasize) to the Spine?

Some common cancers that begin elsewhere in the body and can spread to the spine include the following:

• Lung cancer: The most common cancer to spread to the spine in individuals assigned male at birth 
• Breast cancer: The most common cancer to spread to the spine in individuals assigned female at birth 
• Leukemia (blood cancer)
• Prostate cancer
• Lymphoma (lymphatic system cancer)
• Sarcoma (connective tissue cancer)
• Multiple myeloma [type of white blood cell (WBC) cancer]
• Kidney cancer
• Melanoma (skin cancer)
• Cancers of your gastrointestinal tract
• Thyroid cancer

These cancers most commonly spread to the bony part of the spinal column.

What are the Treatment Options Available for Primary Spinal Tumors?

Your healthcare provider may recommend monitoring with regular MRIs if you have a benign primary tumor that is asymptomatic or mildly symptomatic and doesn't appear to be changing or progressing.

Complete removal of some primary spinal tumors through en-bloc resection can cure them. However, intramedullary tumor types cannot be completely removed without causing significant neural damage.

If your spinal tumor is malignant, you will need cancer treatments like the options listed below.

What are the Treatment Options Available for Metastatic (Secondary) Spinal Tumors?

Spinal metastases cause significant morbidity. Treatment is mainly palliative, but recent advances have improved effectiveness in preserving function with minimal morbidity.

The recent advances allow for:

• An expanded role for surgical decompression of neural elements
• A change in the stereotactic capabilities of radiation oncologists
• A better understanding of the radiobiology of metastatic diseases.

A multidisciplinary radiotherapy, chemotherapy, and surgery approach treats metastatic spinal cancers.

Your healthcare provider may use a combination of the following therapies to treat the metastatic spinal tumor:

Radiation therapy: High doses of X-rays destroy or shrink tumor cells, reducing pain and other symptoms.

Stereotactic Radiosurgery: This procedure uses precise, narrow radiation beams to target tumors with minimal exposure to surrounding tissue, without surgery or invasion.

Chemotherapy: Chemotherapy can destroy cancer cells in the spine and throughout the body. It can be administered through injection or pill and may be used before surgery to shrink tumors.

Surgery: Spine tumor surgery is usually considered in patients with metastatic spinal tumors. When these patients are expected to live 3-4 months or longer and the tumor is resistant to chemotherapy or radiation, surgery is preferred. 

Surgery can preserve your neurologic function, help relieve pain and other symptoms, and stabilize your spine. 

You may be suggested traditional open surgery, or you might have a minimally invasive procedure. Your surgeon may perform vertebroplasty or kyphoplasty. These procedures provide stability and support to your spine, improve mobility, and relieve pain. Surgery can treat up to 10% of people with symptomatic spine metastases.

Recent Updates on Minimally Invasive Spine Surgery

Recently, there has been significant progress in minimally invasive spine surgery (MISS).

Benefits of MISS:

• Preserves normal anatomy
• Quicker postoperative recovery and return to regular life
• Less bleeding during the procedure 
• Fewer postoperative complications.

Asia is typically perceived as the hotspot of modern minimally invasive (MIS) and endoscopic spinal (ES) surgery.

MISS Technology includes the following:

1. Endoscopy: The endoscope has revolutionized the treatment of spine diseases and is now a widely used surgical method.
2. Robotics: Robotic systems are increasingly used in spine surgery due to their precision, dependability, and efficiency. They can help prevent physical and mental exhaustion in surgeons, leading to better outcomes. However, their high cost limits their use. As costs decrease, robotic systems may become more prevalent in spine surgery.
3. Augmented reality-assisted spine surgery: AR-assisted spine surgery has been proven to increase the accuracy of pedicle screw placement and improve the surgical field using radiological guidance. Compared with traditional free-hand surgery and conventional navigation techniques, AR systems have superior workflow accuracy and lower radiation exposure for surgeons and patients.

To Conclude

Spine tumors, whether harmless or harmful, can disrupt life and cause discomfort. Thankfully, there are ways to detect them early and treat them. There are surgeries, radiation, and even newer treatments like targeted drugs that offer hope and a way to heal.

Talking to others going through the same thing or getting professional help can help patients deal with the challenges.