Spinal Tumor

The signs of a spinal tumor usually appear slowly and can differ widely depending on where the tumor is sitting and how big it is:

• Gradual Onset of Back Pain: This is the most important red flag—pain that is often chronic and keeps getting worse, and it’s not due to a specific injury. The pain is usually felt precisely in the area of the tumor.
• Pain Worsened by Lying Down: This is a key difference from regular back pain. Tumor pain frequently gets worse at night or when you are resting, often interrupting sleep.
• Pain Relief with Standing or Activity: Sometimes, the pain is temporarily eased by moving or standing, which is the reverse pattern of typical mechanical back pain.
• Pain Radiating to other parts of the body: The pain might spread out to your arms, legs, or wrap around your chest wall.
• Loss of Sensation: This includes feelings like numbness, tingling, or reduced sensitivity to hot and cold. It typically starts in the legs and can move up the body.
• Muscle Weakness and Coordination Problems: You might notice your arms or legs feel weak, causing difficulty walking, stumbling, or losing control over fine movements.
• Bowel or Bladder Dysfunction: In more advanced stages, the tumor can press on the nerves that manage bladder and bowel control, leading to incontinence or trouble urinating.
• Spinal Deformity: On occasion, the spine can develop a curve like kyphosis or scoliosis because the tumor has weakened or destroyed a vertebra.

For most tumors that start in the spine (primary spinal tumors), the exact cause remains unknown. They are quite rare. However, tumors that have spread from cancer elsewhere in the body (secondary or metastatic tumors—e.g., from breast, lung, prostate) are much more common.

Risk factors for developing primary spinal tumors include:

• Age: Certain types of tumors show up more often in specific age brackets.
• Gender: Some types, like meningiomas, are seen more frequently in women.
• Genetic Syndromes: A family history of certain inherited conditions, such as Neurofibromatosis Type 1 or 2 (NF1 or NF2) and Von Hippel-Lindau disease, significantly raises the risk of getting specific spinal tumors.
• Previous Cancer: The single biggest risk factor for metastatic spinal tumors is having a history of cancer somewhere else in the body.

Getting a timely and accurate diagnosis is crucial for planning the right treatment and preventing permanent nerve damage. Dr. Jaydev Panchwagh uses a thorough approach:

• Medical History and Physical Examination: This starts with discussing your symptoms, reviewing your health history, and testing your neurological function (checking sensation, muscle strength, and reflexes). The physical exam confirms the location of the pain and any tenderness over the spine.
• Imaging Tests:
  • X-ray: An initial X-ray can show if the bone structure of the vertebrae has changed, such as being destroyed or collapsing.
  • MRI (Magnetic Resonance Imaging): This is absolutely crucial as it gives superb detail of the spinal cord, nerves, and soft tissues, clearly mapping out the tumor’s size, exact position, and how much it is compressing the spinal cord.
  • CT (Computed Tomography) Scan: A CT scan provides great detail of the bony anatomy, which is especially important if the tumor involves the vertebrae.
  • PET Scan: This may be necessary to check for a primary cancer elsewhere in the body if a tumor that has spread (metastatic) is suspected.
• Biopsy: A needle or open surgical biopsy is often necessary before settling on definitive treatment to determine the tumor’s exact type and nature (benign or malignant).

The treatment goals are straightforward: remove the tumor completely (if possible), relieve pressure on the spinal cord and nerves, stabilize the spine, and stop it from coming back. The strategy is always highly individualized based on the tumor type, location, size, and the patient’s general health.

While non-surgical options are considered, neurosurgery is often the definitive treatment.

• Conservative Management:
  • Pain Medication: Using pain relievers and corticosteroids to reduce the swelling around the tumor and ease pain.
  • Observation: For small, slow-growing, benign tumors that aren’t yet causing neurological symptoms, simply watching them with regular MRI scans may be the right approach.
  • Radiation and Chemotherapy: These are frequently used as adjuvant therapies (before or after surgery) or as the main treatment for tumors that are malignant, difficult to access, or have spread (metastatic).
• Advanced Surgical Intervention:
  • When is Surgery Considered? Surgery is the best option when the tumor is causing neurological problems that are getting worse, significant pain, or when a biopsy is required.
  • Microsurgical Resection: This is the main surgical approach for most spinal tumors. Using a surgical microscope, Dr. Panchwagh removes the tumor while meticulously preserving the spinal cord and nerves. This technique is vital for tumors inside the cord or dura to maximize removal with minimal damage.
  • Spinal Decompression and Fixation: For tumors that have invaded the vertebrae (extradural or metastatic), the operation involves relieving pressure on the spinal cord and then stabilizing the spine with screws, rods, and cages if the tumor has compromised the bone structure.
  • Stereotactic Radiosurgery (SRS): A non-invasive technique that delivers extremely focused, high-dose radiation to the tumor, often used for smaller or recurrent tumors as an alternative to conventional surgery.