Spinal Tumors

The UofL Brown Cancer Center offers a comprehensive, specialized program for the treatment of benign and malignant spinal tumors.

Overview

Our Multidisciplinary Brain and Spine Tumor Clinic offers a comprehensive, specialized program for the treatment of benign malignant spinal tumors. When you are treated here, you benefit from the knowledge and experience of some of the region’s most renowned experts.

Our physicians approach spinal tumor care in specialized teams, bringing together incredible skill to give you the highest level of customized care. This personalized care and our partnership with you focus on the most advanced treatments with the least impact on your body.

Your spinal tumor treatment team may include neurosurgeons, radiation oncologists, neuro-oncologists, neuropathologists and nurse practitioners. They collaborate and communicate every step of the way. They are joined by a support staff trained in helping patients with spinal tumors.

Treatment for spinal tumors often includes surgery, and surgical skill is key to successful outcomes. Our surgeons have a high level of experience and expertise that can make a real difference in your treatment and recovery.

And our physicians have at their fingertips the latest technology and techniques to treat spinal tumors.

We are constantly researching newer, more effective and safer surgical and medical approaches for spinal tumors. Numerous clinical trials of new treatments are available for spinal tumors.

Understanding a disease is the first step toward finding the right care. Get the facts about spinal tumors, including the different types, how it starts and who’s at risk.

One person in 100,000, or about 10,000 people a year, in the United States develop spinal tumors. Between 15 and 20 percent of central nervous system (brain and spine) tumors occur in the spine.

Spinal tumors can involve any part of the spine. They can begin in the:

  • Neck (cervical)
  • Back (thoracic)
  • Low back (lumbar or sacral spine)

Spinal tumors can begin in:

  • Nerve cells that make up the spinal cord
  • Soft tissues or muscles that support the spine
  • Bones that make up the spinal column

Tumors that begin in the spine are known as primary spinal tumors. A tumor that has spread from another part of the body to the spine is known as a metastatic tumor.

Spinal tumors can be dangerous even if they are not cancer. As they develop and grow they can cause serious problems by pressing against crucial parts of the spine.

Spinal Anatomy

The spine is made up of bones, muscles and ligaments. They work together to provide structural support to the body and protect nerves that control important body functions, as well as sensation and movement.

Vertebrae are the bones of the spine that are stacked one on top of another beginning at the base of the brain. Around and between the vertebrae are nerves, joints, muscles and cartilage. Five vertebrae joined together in the lower back are called the sacrum. The tailbone (coccyx) includes the bottom three vertebrae.

The inner part of the spine is called the spinal cord. It has:

  • Blood vessels
  • Nerve cells
  • Glial cells that help the brain function

Three layers of tissue (meninges) protect the outside of the spinal cord. They are called the:

  • Pia mater, the inner layer
  • Arachnoid, the middle layer
  • Dura mater, the outer layer

Spinal Tumor Types

Spinal tumors are classified by the types of cells within the tumor. Each type of spinal tumor grows and is treated in a different way.

Intramedullary spinal tumors are within the spinal cord. These include:

  • Astrocytomas
  • Ependymomas
  • Hemangioblastomas

Intradural extramedullary spinal tumors are within the spinal cord covering (dura) but outside the spinal cord. These include:

  • Meningiomas
  • Neurofibromas
  • Schwannomas

Extradural spinal tumors (vertebral column tumors) usually involve cartilage and bone. They may be benign (not cancer) or malignant (cancer).

Benign

  • Osteoblastoma
  • Enchondromas
  • Aneurysmal bone cysts
  • Giant cell tumors
  • Hangiomas
  • Eosinophilic granulomas

Malignant

  • Osteosarcoma
  • Chordoma
  • Chondrosarcoma
  • Ewing’s sarcoma
  • Plasmacytoma

The most common places of origin for cancers that spread to the spine are:

  • Lungs
  • Breasts
  • Prostate
  • Kidneys
  • Thyroid

Lymphomas (a tumor of the blood system) also may spread to the spine and compress the spinal cord.

Risk Factors

Anything that increases your chance of getting a spinal tumor is a risk factor. Little is known about what causes spinal tumors. It is known that certain disorders that run in families may increase your risk of brain tumors or spinal tumors. These include:

  • Neurofibromatosis type 2
  • Von Hippel-Lindau disease
  • Immune system disorders may play a part in spinal cord lymphomas

Not everyone with risk factors gets spinal tumors. However, if you have risk factors, it’s a good idea to discuss them with your health care provider.

Research shows that many cancers can be prevented.

In rare cases, spinal tumors can be passed down from one generation to the next. Genetic counseling may be right for you.

Symptoms of spinal tumors vary from person to person, and by the type and location of the tumor. They are caused by pressure on the spinal cord or nerve roots.

If a spinal tumor presses on the spinal cord it may cause:

  • Back pain that gets worse with time, is not related to activity and is worse when you lie down
  • Weakness that gets worse with time
  • Loss of feeling in certain areas of the body
  • Loss of bowel and bladder control
  • Erectile dysfunction

If a spinal tumor presses against spinal nerve roots it can cause:

  • Pain
  • Numbness
  • Tingling
  • Weakness

If pressure continues, muscles may waste away. Walking may become difficult.

These symptoms do not always mean you have a spinal tumor. However, it is important to discuss any symptoms with your doctor, since they may signal other health problems.

Blood tests, imaging exams and even surgical procedures are used to check for cancer.

At UofL Brown Cancer Center, specially trained doctors called neuropathologists find and diagnose spinal tumors. We have the most modern and accurate equipment available to pinpoint spinal tumors and find out exactly the extent of the disease.

Getting an accurate diagnosis for a spinal tumor is very important. It helps your doctor plan your care and may help increase the chance of successful treatment.

If you have symptoms that may signal a spinal tumor, your doctor will examine you and ask you questions about your health, your lifestyle and your family medical history.

One or more of the following tests may be used to find out if you have spinal tumor and if it has spread. These tests also may be used to find out if treatment is working.

MRI (magnetic resonance imaging): This is the best way to look at all the parts of the spinal cord and spine. CT (computed tomography) scans also may be used.

Biopsy: A biopsy usually is needed to diagnose the type of spinal tumor, especially primary spine cancer. A biopsy may not be needed for secondary spine cancer. Often a biopsy requires surgery. Sometime it can be done with fine-needle aspiration (FNA).

Customized Care

We know that you have the highest chance for successful treatment when your spinal tumor care is designed especially for your specific situation. That’s why we customize your therapy to include the most advanced treatments with the least impact on your body.

Spinal tumor care often requires complex and delicate surgery. The goal is to remove as much of the tumor as possible, while not disturbing important parts of the spine and surrounding structures. This requires a high degree of skill.

Our Treatments

If you are diagnosed with spine cancer, your doctor will discuss the best options to treat it. This depends on several factors, including the type and location of the tumor and your general health.

One or more of the following therapies may be recommended to treat the tumor or help relieve symptoms.

Corticosteroids: These drugs (such as dexamethasone) may be given to reduce swelling if a spinal tumor is pressing against the spinal cord. These tumors are treated as soon as possible, often with surgery.

Surgery: Some spinal tumors can be removed by surgery. If the entire tumor cannot be removed, radiation therapy may be given after surgery to relieve pressure on the spinal cord.

Like all surgeries, spinal tumor surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. Our spine surgeons are among the most skilled and recognized in the world. They perform a large number of surgeries for spinal tumors each year, using the least-invasive and most advanced techniques. If surgery is not possible or cannot remove the entire spinal tumor, we often are able to treat the tumor using other leading-edge treatments.

Radiation therapy may be given alone or after surgery to relieve pressure on the spinal cord. Cyberknife is an advanced form of treatment that focuses radiation precisely on the spinal tumor, causing less impact to healthy tissue. The CyberKnife’s robotic arm will position itself around your body, delivering radiation directly to your tumor with pinpoint precision. Depending on your diagnosis and the level of your tumor’s complexity, treatment involves one to five outpatient sessions, each lasting about 30-60 minutes.

Chemotherapy: We offer the most up-to-date and advanced chemotherapy options for spinal tumors. These drugs may be taken orally or by injection. They may be given alone or with other treatments.

Targeted therapies: These newer agents are used to help fight some types of spinal tumors. Targeted therapies attack cancer cells by using small molecules to block pathways that cells use to survive and multiply.

Clinical Trials

We participate in many clinical trials for spinal tumors. Sometimes they are your best option for treatment. Other times, they help researchers learn how to treat cancer and improve the future of cancer treatment.

Our doctors at UofL Brown Cancer Center are proudly part of UofL Physicians and the UofL School of Medicine.

We believe knowledge comes from questioning the status quo, discovering more about disease and using that knowledge to improve the health of our community. Our physicians are the teachers and researchers at the UofL School of Medicine, involved in the research and development of new treatments and cures for cancer. This means you receive the most advanced and appropriate treatment, even for complex or rare conditions.

To learn more about the physicians who make the academic difference in treatment for spinal tumors, visit the UofL Physicians website here.