What Is a Spinal Tumor?

Spinal tumors refer to primary and secondary tumors that occur in the spine. The overall incidence of primary spinal tumors is approximately 0.4%. Most adolescent spinal tumors are benign, while young and middle-aged patients are more likely to have malignant tumors. Benign tumors often involve the posterior structure, while malignant tumors involve the vertebral body. Primary benign spinal tumors generally progress slowly and have a long course of disease; malignant spinal tumors progress faster, have a shorter course of disease, and appear more rapidly in clinical symptoms, accounting for about 10% of new malignant bone tumors each year.

Basic Information

English name: Spinal Neoplasms
Visiting department: Orthopedics, Oncology

Common locations: spine
Common causes: Unknown cause
Common symptoms: Pain, local mass, spinal deformity, neurological dysfunction, etc.

Causes of spinal tumors

Causes of spinal tumors: The causes of spinal tumors are the same as those of bone tumors, and the causes are more complicated. At present, there are five kinds of theories:

(1) Viral theory of column tumors. Animal experiments have confirmed that the virus can induce osteosarcoma.

(2) Chronic stimulation theory of spinal tumors. Certain physical factors such as radiation, radioisotopes, and certain chemical factors such as methyl bile onion can induce osteosarcoma.

(3) Heterotopic remnants of embryonic tissues of spinal tumors. Residual embryonic chordal and cartilage tissue can cause chordoma and chondrosarcoma.

(4) Malignant theory of spinal tumors.

(5) Genetic theory of spinal tumors Genes in normal cells change to produce tumors, tumor cells continue to proliferate, and inherit their biological characteristics. Clinically seen hereditary multiple exostosis is hereditary and so on.

Clinical manifestations of spinal tumors

Spinal tumors are mainly manifested as back pain, local masses, spinal deformities, and neurological dysfunction.

Pain

It is the most common and major symptom in patients with spinal tumors. 80% to 95% of primary spinal tumors are the first symptoms and sometimes the only symptoms at the time of diagnosis. It mainly includes tumor-induced pain and mechanical pain. Generally, the pain is more obvious at night, which can be reduced during the day due to activities.

2. Local mass

Because spine bone tumors mostly occur in the vertebral body, and the vertebral body is deeper, it is difficult to find on the body surface. Therefore, patients with a mass as the first manifestation are not common, mainly seen in tumors of the cervical spine or the appendix structure of the spine. Spinal malignant tumors grow rapidly and often cause compression of surrounding tissues, so local pain and discomfort are often manifested. Metastatic spinal tumors, due to the presence of primary lesions, and metastatic tumors generally have a high degree of malignancy, grow rapidly, and are prone to induce spinal pain and neurological symptoms. They are often found before large tumors are formed.

3. Spine deformity

Spinal deformities caused by spinal tumors are not uncommon, and their main mechanisms include: damage to the vertebral body and / or attachments by the tumor; spastic response of the tissue around the spine; and large tumors squeeze the surrounding structure. Such as osteoid osteoma can often appear scoliosis deformity to the side of the lesion, the apex of the lateral curve is mostly the location of the lesion.

4. Nerve dysfunction

Spinal nerve compression can be caused by tumor invasion directly, or by deformity caused by tumor destruction of bone structure. Because spinal tumors are mainly located in the vertebral body, they often compress the pyramidal tract or anterior horn cells from the front, so they often show motor impairment first, and the clinical symptoms vary depending on the degree and location of spinal nerve compression, such as anterior spinal cord. Horn syndrome, posterior horn syndrome, and hemisection syndrome.

Spinal tumor examination

Examination of patients with spinal tumors mainly includes: X-rays, CT, and magnetic resonance. For metastatic lesions, feasible whole body bone scan (ECT) and single photon emission computed tomography (SPECT).

Spinal tumor diagnosis

It can be diagnosed according to clinical symptoms, signs, imaging examination, combined with laboratory examination, such as ESR. If necessary, a CT-guided biopsy may or may not be diagnosed.

Differential diagnosis of spinal tumors

Spinal suppurative inflammation

Before the onset, patients often had bloated skin or other suppurative lesions, high body temperature, obvious symptoms of poisoning, obvious pain in the affected area, limited movement, and swelling and tenderness of local soft tissue. X-rays show bone destruction, intervertebral narrowing, dead bone formation, and abscess-free formation. Bacterial and histological examination should be performed to confirm the diagnosis.

2. Degenerative spine disease

Intervertebral discs and ligaments protrude into the spinal canal causing compression of the spinal cord and nerves. Almost all imaging signs of spinal degeneration after middle age exist, and the differential diagnosis of spinal cord tumors requires detailed neurological evaluation, supplemented by imaging examination.

3. Spinal tuberculosis

There are many chronic poisoning symptoms such as low fever and night sweats, and the lesions erode the intervertebral disc and the corresponding vertebral body edge. The paravertebral cold abscess is helpful for differential diagnosis.

Spinal tumor treatment

For spinal tumors, surgical resection is advocated, which affects the stability of the spine. Spinal column internal fixation should be performed to maintain the stability of the spine. For patients with spinal cord and nerve root compression symptoms, surgery should be performed under surgical microscope to relieve the nerve compression. Malignant tumors can be biopsied to confirm the pathology, and then treated with radiotherapy or other methods according to the pathological nature. However, for malignant spinal tumors that affect the stability of the spine, tumor resection and spinal internal fixation can be performed to achieve the purpose of relieving symptoms and maintaining spinal stability. Provide the basis for postoperative chemoradiotherapy. Rehabilitation should be performed for persons with physical impairments.