• Extradural (vertebral) tumors. These are tumors that begin in the bones of the spine. Most of these tumors are cancerous tumors that have metastasized, or spread to the spine from another area in the body, such as the prostate, kidney, breast or lung. Some of these types of tumors include osteosarcomas (osteogenic sarcomas) and Ewing’s sarcoma, an aggressive tumor usually found in young adults. Another cancerous disease, called multiple myeloma, affects the bone marrow. There are noncancerous extradural tumors too, including osteoid osteomas, osteoblastomas and hemangiomas that can develop in the bones of the spine.
• Intradural-extramedullary tumors. These are tumors that develop in the spinal cord’s arachnoid membrane (meningiomas) and in the nerve roots that extend out from the spinal cord, such as schwannomas and neurofibromas. These tumors may be cancerous or noncancerous.
• Intramedullary tumors. The intramedullary tumors begin in the supporting cells within the spinal cord. Most are either astrocytomas or ependymomas. These types of tumors can be either noncancerous or cancerous.

Symptoms of spinal tumors vary depending on the location and type of spinal tumor. Back pain is one of the most common symptoms, but there are others including:

• Muscle weakness or loss of feeling in arms or legs
• Difficulty walking or clumsiness and falling
• Decreased sensitivity to pain as well as hot and cold temperatures
• Loss of bowel or bladder function
• Paralysis occurring in various parts of the body

There are no known causes of spinal tumors. Researchers say that environment may play a role and so may defective genes. There are some inherited conditions, such as neurofibromatosis 2, which can lead to a spinal tumor.

Surgery is the treatment of choice depending on the location of the tumor. When the tumor can’t be removed completely, surgery may be combined with chemotherapy or radiation therapy. Radiation is used following an operation to eliminate the remnants of tumors that can’t be completely removed. It also is used for inoperable tumors. Stereotactic radiosurgery is often used on tumors because it can deliver a high dose of radiation to a targeted area. Chemotherapy is often administered for spine tumors. Chemotherapy uses medications to destroy cancer cells or stop them from growing. Depending on the condition, a physician may recommend a combination of radiation and chemotherapy treatment.

Patients with spinal tumors should see a board-certified spine surgeon such as Dr. Kern Singh at Midwest Orthopaedics at Rush. Dr. Singh’s immediate goals for each patient are to eliminate pain caused by the spinal tumor, restore or preserve neurologic function, and stabilize the spine. The spinal tumor may be approached surgically from the front (anterior) or back (posterior) of the body.

Surgery may include tumor resection (partial removal) or excision (complete removal). When the tumor is removed (partially or completely), pain and neurologic problems may clear up. Spinal instrumentation and fusion are procedures used to reconstruct and stabilize the spine. These procedures help “fuse” and secure the area around where a disk has been damaged or removed. Minimally invasive spine surgery allows for the same tumor resection as an open procedure with the added benefits of decreased blood loss, less pain, faster recovery, and shorter hospitalizations. The number of days the patient spends in the hospital after surgery is partially dependent on the procedure performed. Thereafter, the patient’s care is monitored by periodic office visits and re-evaluation by the Dr. Singh.