What is a Spinal Tumor?
A spinal tumor refers to masses that originate from the bony structure of the spine, soft tissues, or the spinal cord itself, or tumors that spread to the spine from other organs or tissues.
If the tumor originates from the spine itself, it is called a Primary Spinal Tumor. If it results from the spread of cancer from other organs or tissues, it is referred to as a Metastatic Spinal Tumor.
The most common spinal tumors are metastatic ones. Among these, breast cancer, lung cancer, and prostate cancer are the most frequently occurring types that metastasize to the spine. Due to the vascular structure of the spine, it is one of the areas most prone to bone metastases.
What Symptoms Do Spinal Tumors Cause?
In very small masses, there may be no symptoms, but depending on the size of the mass, its location on the spine, and the amount of pressure on the spinal cord, patients often experience the following symptoms:
- Pain in the back, neck, or lower back
- Numbness, tingling, weakness, and pain in the arms and legs (especially at night) in patients with spinal cord compression; in advanced cases, paralysis
- Fatigue, weakness, and loss of appetite in some cancer-related cases
How is a Spinal Tumor Diagnosed?
The gold standard for diagnosing spinal tumors is imaging techniques (MRI, CT, PET CT, scintigraphy, direct radiography) and biopsy. In cases suspected of a tumor through imaging, a biopsy must be conducted to confirm the diagnosis, except in some special situations.
Treatment of Spinal Tumors
There are differences in the surgical approach between primary spinal tumors and metastatic spinal tumors. The main goal in both is to ensure that the patient lives pain-free, comfortably, and with high quality, retaining functional arm and leg capabilities without losing their ability to function for a long, healthy life. In primary tumors, the goal is always to perform an en bloc resection, which means removing the tumor along with the surrounding healthy tissues without entering the tumor itself. Although this surgical method presents significant challenges, the risk of complications during and after the surgery is somewhat higher. It must be performed in centers with experienced teams and good intensive care facilities.
While en bloc resection can be performed in very few cases of metastatic tumors, with advancements in radiation oncology tools such as stereotactic radiotherapy or radiosurgery, separation surgeries have become more prominent. In some metastases, closed surgeries combined with radiotherapy are sufficient, while in other cases, radiotherapy and/or chemotherapy alone may suffice. The type of treatment depends on various factors such as the type of tumor, its location, whether it is compressing the spinal cord, the patient's age and general condition, and the tumor's sensitivity to radiotherapy. The final decision is made through a joint consultation between the spinal surgery specialist, radiation oncologist, and medical oncologist.