Spinal cord tumors are tumors -arising from inside the spinal cord or its surrounding membranes or cancers which spread to spinal cord mostly onto its outer most covering called ‘epidural space’.
Spinal cord tumors starts in everywhere along the spinal cord from cervical region down to the thoracal, lumbar or sacral segments. The typical findings of a spinal cord tumor is back pain which is worsened at night and and maybe excruciating that wakes up the patients from sleep. Tingling, burning sensation, loss of sensation in arms and legs, decrease in muscle strength or paralysis/plegia, loss of urinary and fecal control are among the most common symptoms of a spinal cord tumor.
Generally speaking, tumors inside the cord tissue are called ‘intramedullary tumors’ which include astrocytomas and epandymomas mostly. Tumors in between the outer membrane of the cord (dura matter) and the cord susbtance are called ‘intradural extramedullary tumors’s which include the meningiomas, schwannomas, and nerve sheath tumors mostly.
The rationale behind the surgical treatment of spinal cord tumors is to remove these masses gently under microscope applying micro-neurosurgical techniques to preserve the integrity and the functioning of this precious tissue-spinal cord. Monitoring of nerve functions at all times during the course of surgery is of vital importance and this neuro-monitoring tool is applied in the contemporary spinal cord surgeries.
Fortunately, spinal cord tumors are less common compared to the brain tumors (4-5 times less) and they tend to be more benign in general.
We mostly prefer approach to these tumors from the behind of the spinal column by removing the posterior arches of the vertebrae (laminectomy or laminoplasty). In seldom cases, we can approach the tumors from the front through opening the chest and abdominal cavity or in a combined fashion based on the location and the extention of the spinal cord tumor.
Following surgery, some patients may require radiotherapy and/or chemotherapy if the pathology report verifies a malignant tumor, a.k.a cancer.
Physiotherapy (neuro-rehabilitation) maybe needed in some patients following surgery and it is started right after the removal of the surgical sticthes (as early as 2 weeks).
Spine tumors are bony tumors which originate inside the bony structures of the vertebrae or tumors which spread to the vertebrae (metastatic). These tumors may infiltrate or compress the spinal cord too which resides and extends in the hole all along the spinal column- bony column.
Spine tumors range from benign (good) to malignant (cancer) tumors and they are diverse.
Hemangiomas, osteoid osteomas, osteochondroma, aneurysmal bone cyst, giant cell tumors are generally benign spine tumors while chordomas, ewing’s sarcoma, osteosarcoma, multiple myeloma are cancerous, malignant spine tumors.