Tumors in spine can be divided into two groups
- Tumors in the vertebra
- Tumors in the nervous tissue
Tumors of the vertebra
These are further divided into :
- Primary tumors, which arise from vertebra. This include benign tumors such as osteoid osteoma, osteoblastoma, aneurysmal bone cysts and malignant tumors such as chondrosarcoma and osteosarcoma.
- Metastases: Tumors, which spread from other sites such as breast, prostate, kidney, thyroid and lungs into the vertebral column. Myeloma, which are tumors of haemopoetic tissue, commonly involve spine.
Tumors of the nervous tissue
These are divided into those, which occur within the spinal cord called intramedullary tumors.
Clinical presentation and management
The symptoms include pain, which is constant and present at rest. There may be loss of appetite and weight loss. If the tumor compresses the spinal cord, patient may develop neurological symptoms such as weakness in les and loss of bladder and bowel control.
The management of tumors needs a multi-disciplinary approach with the oncologist, radiotherapist, and social counselor involved in the team. Investigations are done to stage the tumors to determine their nature, extend and spread. Theses include x-rays, MRI scan, CT scan, bone scan, ultrasonography and tumor markers in blood. Surgery for primary tumors is curative and involves Surgery for metastasis is usually palliative and indicated in severe pain or neurological defect not responding to medical treatment. Surgery involves debulking of tumor tissue and stabilization using vertebral body cages or posterior instrumentation such as pedicular screws. Tumors of nerve tissue and their coverings require surgical excision.