Tumors of the spine and spinal cord

Intermittent back pain is a common problem. Most cases of pain are the result of normal stress and strain or degenerative changes that occur with age. But sometimes the cause of pain can be a spinal tumor – a malignant or benign neoplasm that develops in the spinal cord, its membranes or in the bones of the spine.

Tumors of the spine and spinal cordare rather infrequent pathologies and make up no more than 0.5% of all oncological diseases. Like tumors in other organs, they can be benign or malignant. Tumors of the spinal cord can come from both its membranes (extramedullary) and from the white or gray matter itself (intramedullary). The treatment of tumors in the vast majority of cases is surgical: the tumor is removed with the integral use of an operating microscope.

The reasons

The spine consists of 24 small bones – vertebrae, placed one above the other, plus the sacrum and coccyx. Most adults have 7 vertebrae in the neck (cervical vertebrae), 12 vertebrae in the chest area (thoracic vertebrae), and 5 vertebrae in the lower back (lumbar vertebrae). The sacrum consists of five fused vertebrae between the pelvic bones. The coccyx is formed from 3-5 bones fused at the very end of the spine.

Each vertebra has a hole in the center, like a hole in a donut. The openings located one above the other form a hollow canal (vertebral canal) that contains and protects the spinal cord and its nerve roots.

Spinal cordis a long bundle of nerve fibers that carries information from and to the brain. It starts at the base of the skull and runs to the second lumbar vertebra, located in the lower back. The spinal cord is traditionally 37-42 cm long, but its diameter varies in different regions of the spine. At its widest points – in the cervical and lumbar regions, where many nerves are located, it has the diameter of a thumb.

Structurally, the spinal cord is a 2-layered tube. The butterfly-shaped inner layer (gray matter) contains the nuclei of nerve cells. The outer layer consists mainly of white matter, nerve fibers (axons) that transmit sensory information, such as the sensation of pain or temperature, from the body to the brain and conduct motor impulses from the brain to muscles, organs, and glands. Axons are combined into 31 pairs of spinal nerves with one sensory nerve root and one motor nerve root in each pair. Paired nerves exit the spinal cord between each vertebra.

The back of the brain is surrounded by three protective membranes, consisting of connective tissue. The inner lining is the pia mater. In the middle is the arachnoid, so named because it resembles the web of a spider. The tough outer sheath to which the spinal nerves are attached is called the dura mater.

Symptoms

Back pain, especially in the middle or lower part of the back, is the most common symptom of both benign and malignant spinal tumors. The pain can often get worse at night or when you wake up. It can also spread through the spine to the hips, legs, feet, or arms and may get worse over time despite treatment.

Depending on the location and type of tumor, other signs and symptoms may develop, especially as the cancer grows and affects the spinal cord or nerve roots, blood vessels, or bones of the spine.

These signs include:

• Loss of sensation or muscle weakness, especially in the legs
• Difficulty walking, sometimes leading to falls
• Decreased sensitivity to pain, heat and cold
• Loss of bowel or bladder function
• Paralysis, which can be of different localization and severity depending on where the tumor is located and what part of the spinal cord it compresses
• Scoliosis or other spinal deformity resulting from a large but benign tumor.

Spinal tumors progress at different rates. In general, malignant tumors grow rapidly, while benign tumors can develop slowly, sometimes lasting for several years before problems appear.

Diagnosis

Spinal tumors can sometimes go undiagnosed because they are rare and their symptoms resemble those of more common diseases. For this reason, it is especially important that the doctor take a complete medical history and perform a physical and neurological examination. If a spinal tumor is suspected, your doctor may order one or more of the following tests to confirm the diagnosis and locate the tumor:

• Spinal magnetic resonance imaging (MRI)
• Computed tomography (CT)
• Myelography
• Biopsy
• Treatment.

Ideally, the goal of treating a spinal tumor is to remove it completely, but this goal is complicated by the risk of irreversible damage to the surrounding nerves. Doctors must consider the patient’s age, general health, type of tumor, whether it is primary or has spread to the spine from other organs (metastasized).

According to the site www.neurosurgery.com.ua

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