Spine Tumours

Spine tumour is the abnormal growths of uncontrolled tissues or cells in and around the spinal cord.  Tumours can either be cancerous (malignant) or non-cancerous (benign). Some of the commonly occurring benign spinal tumours are osteoma, osteoblastoma, hemangioma, and osteochondroma. Most commonly occurring malignant spinal tumours are chondrosarcoma, Ewing’s sarcoma, lymphoma, osteosarcoma, and multiple myeloma. Tumours that begin in the spine are called as primary spinal tumours. Tumours that spread to the spine from other parts such as the breast, prostate, lung, and other areas are called secondary spinal tumours.

The cause of primary spinal tumours is not known but may occur with genetic defects.

Secondary spinal tumours occur when the cancer cells arise from kidneys, lungs, breasts, and spreads to the spine. Other causes include

• Rapid division of cancer cells in the nerves, bones, or cartilage of the spine
• Exposure to radiations and chemicals
• Hereditary – Neurofibromatosis is a tumour of the spinal nerves

People with spine tumour experience persistent and chronic back pain, numbness, burning and tingling sensation, loss of sensation in legs, arms, ankle, knee, and difficulty in balancing, and also experience bladder or bowel control problems.

Spine cancer can be diagnosed by neurological examination which identifies the exact location of the tumour. Other imaging tests done to confirm the spinal tumour may include cerebrospinal fluid (CSF) examination, myelogram, and spine computed tomography scan, spine magnetic resonance imaging scan, and spine X-ray. In addition to these tests, bone scan and positron emission tomography (PET) scan are also done. After the tumour is found, biopsy is done to identify the type of tumour and provide necessary treatment.

Medications such as corticosteroids and anti-inflammatory drugs are prescribed to reduce inflammation and swelling around the spinal cord. External braces are also used which provide support and control pain.

Other treatments include chemotherapy, radiation therapy, surgery, and physical therapy which may provide permanent relief.

• Surgery: It is done to remove the tumour confined only to one portion of the spine. To minimize nerve damage, electrodes are used to test different nerves of the spine. In some cases, sound waves are used to break tumours and the remaining tissues are removed.
• Radiation therapy: This method uses high beam of radiations to destroy the cancer cells. It is used after surgery to destroy the remaining cancer cells. An advanced device called cyberknife, painless and non-invasive treatment that passes high doses of radiations to the targeted areas of the spinal cord is used in radiotherapy.
• Chemotherapy: Combination of anti-cancer drugs is used to destroy the cancer cells. Chemotherapy is used to shrink the cancer cells, to stop the division of cancer cells, and prevent them from spreading to surrounding tissues. The drugs enter the bloodstream and reach the cancer cells to destroy them. Some of the commonly used drugs are methotrexate, doxorubicin, cyclophosphamide, carboplatin, and ifosfamide.

Some of the complications observed after surgery are temporary loss of sensation, nerve tissue damage, and bleeding

Physical therapy: Exercises may be needed to improve muscle strength and the ability to function independently.