A spine tumour is a growth in the bones of the spine, in the coverings of the spinal cord or, rarely, within the cord itself. In adults the most common by far are metastases, cancer that has spread from the breast, lung, prostate, kidney or elsewhere, or myeloma. Tumours that start in the spine include benign ones such as haemangioma, osteoid osteoma, schwannoma and meningioma, and rare malignant ones such as chordoma and chondrosarcoma.
What matters most is whether the tumour threatens the spinal cord or the stability of the spine. Treatment aims to protect nerve function, relieve pain and keep the spine stable, and to remove the tumour when that is realistic.
Symptoms
- Back or neck pain that is constant, worse at night or when lying down and not related to activity
- Pain that spreads around the chest like a band or down an arm or leg
- Weakness, heaviness or stiffness in the legs, or an unsteady walk
- Numbness or pins and needles, including in the saddle area
- Difficulty passing urine, leaking, constipation or loss of bowel control
- A curve of the spine or pain in a child that progresses
- Pain from a vertebral collapse after minimal strain
Causes and risk factors
Metastases reach the spine through the bloodstream, and the vertebrae are among the most frequent sites of spread because of their rich blood supply. Myeloma and lymphoma arise in the marrow. Schwannomas and meningiomas are usually sporadic, but multiple ones suggest neurofibromatosis type 2 or schwannomatosis. Ependymomas and astrocytomas grow within the cord, and haemangioblastomas occur in von Hippel-Lindau disease. Chordoma develops from remnants of embryonic tissue at the base of the skull and the sacrum. Previous radiotherapy is a rare cause.
How it is diagnosed
- MRI of the whole spine: The most important test. It shows the tumour, cord or nerve compression and other affected levels. It is needed within 24 hours when cord compression is suspected.
- CT scan: Shows bone destruction and stability, and guides planning of fixation.
- CT-guided biopsy: Establishes the tissue diagnosis. For a suspected primary tumour, it is planned with the surgeon so that the track can be removed later.
- Body scans and blood tests: CT or PET-CT to find a primary cancer, with myeloma screen and PSA where relevant.
- Neurological examination and stability scoring: Determines urgency, and scoring systems help decide whether the spine needs fixation.
Treatment options
- Steroids: Dexamethasone is started immediately when the cord is compressed by a malignant tumour, to reduce swelling while definitive treatment is arranged.
- Decompression and stabilisation surgery: Relieves pressure on the cord and fixes the spine with screws and rods, by open or minimally invasive techniques.
- Radiotherapy and stereotactic radiosurgery: Conventional radiotherapy for pain and cord compression, and high-precision stereotactic treatment in 1 to 5 sessions for durable control of selected metastases.
- Microsurgical removal: For schwannomas, meningiomas and tumours within the cord, under nerve monitoring. Complete removal usually settles benign tumours.
- En bloc resection: Removal in one piece with wide margins for chordoma and chondrosarcoma, a complex operation done in specialist centres, often followed by proton or carbon ion therapy.
- Vertebroplasty, kyphoplasty and systemic treatment: Cement augmentation for painful collapse, and drug treatment of the underlying cancer together with bone-strengthening agents.
When it is urgent
New leg weakness, difficulty walking, numbness around the genitals or back passage, or new trouble passing urine or controlling the bowels in someone with back pain or a known cancer must be treated as an emergency. Go to the nearest hospital the same day, because delay of even a day can mean permanent paralysis. Do not get on a plane with these symptoms.
Travelling to Türkiye for treatment
Spinal cord compression has to be treated locally and immediately. Travel is appropriate for stable situations: a second opinion on imaging, planned removal of a benign tumour such as a schwannoma or meningioma, with around 2 weeks' stay, a defined stereotactic radiosurgery course, or assessment for en bloc resection of a primary tumour. Ask about flying and sitting for long periods after spinal fixation. Rehabilitation, oncological treatment of the primary cancer and follow-up MRI scans should be arranged at home.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
الأسئلة المتكررة
Is a tumour in my spine always cancer?
No. Haemangiomas are seen in about one in ten adult spines and are almost always harmless. Schwannomas and meningiomas are benign too. A tumour in someone with a history of cancer is more likely to be a metastasis.
Will I be paralysed?
Most people are not, particularly when pressure on the cord is recognised and treated early. Function at the time of treatment is the best predictor of function afterwards.
Surgery or radiotherapy?
It depends on stability, the degree of cord compression, the tumour's sensitivity to radiation and your general health. Often the two are combined.
Is surgery inside the spinal cord safe?
It carries real risk of new weakness or numbness. Continuous nerve monitoring lowers this risk, and surgeons may leave a little tumour behind to protect function.