Spinal Cord Tumors 

Introduction
Spinal cord tumors may originate in the spinal cord or result from the spread of cancer from another location in the body.  Your spinal cord transmits sensory, movement, and reflex information between your brain and body.  Spinal cord tumors need prompt treatment to prevent serious complications including disability, paralysis, or death.  Spinal cord tumors can be treated with medications, surgery, radiation, or a combination of treatments.

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Anatomy
The spinal cord is part of the central nervous system that extends from the brain.  It is located within the neck and upper back areas of your spine.  The spine encases and protects your spinal cord. 
 
Three meninges, the dura matter, pia matter, and arachnoid, cover the spinal cord.  Thirty-one pairs of spinal nerves originate from the spinal cord and extend throughout your body.  The spinal cord conducts sensory, movement, and reflex information between your body and brain. 

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Causes
The cause of primary spinal cord tumors is unknown.  Primary spinal cord tumors originate in the spinal cord.  Some primary spinal cord tumors are associated with genetic defects.  Cancer occurs when cells grow abnormally and out of control instead of dividing in an orderly manner.

Spinal cord tumors that develop within the cord are called intramedullary.  Spinal cord tumors that occur within the meninges, the membranes that cover the spinal cord, are called extramedullary or intradural.  Tumors that are between the meninges and the spine bones are termed extradural.  Metastasized tumors result from cancer that originates elsewhere and spreads to the spinal cord.  Lung, breast, prostate, kidney, and thyroid cancer may metastasize to the spinal cord.

As it grows, a spinal cord tumor may affect the structures and function of the spinal cord.  Primary spinal cord tumors grow slowly, over weeks to years.  Metastatic tumors tend to grow quickly. 

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Symptoms
Symptoms of spinal cord tumors can vary and depend on the location and size of the tumor.  Spinal cord tumors can cause back pain that is worse when you are lying down, sneeze, or cough.  The pain is usually severe and may become worse over time.  The pain may spread to your hip, leg, foot, or arms.  You may feel abnormal sensations or a lack of sensation, particularly in your legs.  It may get worse over time.  Your legs, hands, or other areas of your body may feel cold.

Your muscles, particularly in your legs, may feel weak and become weaker over time.  It may be difficult to walk, and you may fall.  You may not be able to retain or control your bowels or urine.
 

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Diagnosis
A spinal cord tumor is diagnosed with a series of neurological examinations and tests.  Your doctor will test the strength, motion, and reflexes in your arms and legs.  Areas of your skin may be tested for loss of sensation or temperature.  Your spine will be examined for tender points. 

Imaging tests are used to produce pictures of a spinal cord tumor.  X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans can provide more information about the size and location of a tumor.  A myelogram uses dyes with an X-ray or CT scan to visualize the tumor better.
 

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Treatment
Prompt treatment for spinal cord tumors is very important to help prevent nerve damage, spinal cord compression, or paralysis.  The goal of treatment is to remove the tumor or relieve compression to preserve as much function as possible.  Medications may be used to reduce swelling and prevent compression.  Micro-laser surgery may be used to remove the tumor.  Radiation therapy may be used with surgery, or in some cases, instead of surgery.  Chemotherapy may be recommended in some cases, but overall, it has not proven to be effective against most spinal cord tumors.
 
Radiation therapy is a painless procedure.  Your doctor will prescribe the amount and length of treatment based on your condition.  Radiation therapy is usually delivered in several doses over a period of time.  There are different types of radiation therapy that may be used to help treat spinal cord tumors.
 
External beam radiation uses high-energy beams to disrupt the growth of cancer cells. Radiation damages all cells both healthy and cancerous, in the exposed area.  Radiated cancer cells are not able to repair themselves or replicate.  Your doctor may prescribe medication to prevent the side effects of radiation.
 
State-of-the-art technology has advanced radiation methods to help make them more effective and tolerable.  Three dimensional conformal radiation therapy (3D CRT) maps a tumor with imaging scans before treatment.  Magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, and positron emission tomography (PET) scans are used to produce images of a tumor and its surrounding tissue.  The images from the scans are combined with a computer called a multi-leaf collimator (MLC).  The MLC produces a 3D image of the cancer and formulates a treatment plan specifically for the 3D image.  This allows direct multiple beams of radiation to be targeted precisely at the tumor and spare as much healthy tissue as possible.
 
Stereotactic Radiosurgery (SRS) and Stereotactic Radiotherapy (SRT) are both methods of delivering radiation therapy to spinal cord tumors.  SRS or SRT may be used instead of or along with surgery.  SRS involves a single radiation treatment.  SRT uses a series of treatments over time.  Both methods spare healthy tissues because the radiation precisely targets the cancer.
 
With SRS and SRT, sophisticated software controls the radiation treatment beams to match the exact shape of a tumor or lesion.  The beams may be moved to penetrate the cancer from different angles.  The state-of-the-art equipment is able to adjust for minor patient movements.  This precision delivery method quickly allows the cancer to receive the full dose of radiation, while the surrounding healthy tissue only receives a small percentage of radiation.  SRS and SRT are useful for treating tumors in delicate tissue areas, such as the brain and spinal cord.
 
The experience of cancer and cancer treatments can be an emotional process for people with cancer and their loved ones.  It is important that you receive support from a positive source.  Some people find comfort in their family, friends, co-workers, and faith.  Cancer support groups are another good option.  They can be a good source of information and support from people who understand what you are experiencing.  Ask your doctor for cancer support group locations in your area.

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Prevention
Early diagnosis and treatment is associated with the best outcomes.

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Am I at Risk
The cause of primary spinal cord tumors is unknown, so risk factors have not been identified as of yet.  You may be at risk for metastatic spinal cord cancer if you have the type of cancer in another part of the body that tends to metastasize to the spinal cord.

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Complications
Spinal cord tumors may cause impairments, disability, or paralysis even with surgery.  Rehabilitation therapy may be necessary to help improve independent functioning.  Untreated spinal cord tumors may lead to significant disability or death.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.