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Why Is a Spinal Cord Tumor So Hard to Diagnose?

Spinal cord tumors are rare — so rare that primary spinal cord tumors account for only half of one percent of all diagnosed tumors. The rarity of a typically benign primary spinal tumor that originates in the spine also makes a spinal cord tumor difficult to diagnose. Why? Because the earliest spinal cord tumor symptoms are similar to symptoms of other more common back conditions.

Spinal cord tumors are often so slow-growing that it can be years before serious spinal cord tumor symptoms or neurological symptoms occur, making a spinal cord tumor difficult to diagnose. Back pain is a common early spinal cord tumor symptom, but spinal cord tumors are so rare that most doctors will begin by investigating other more probable causes of back pain first.

In addition to back pain, other spinal cord tumor symptoms include:

  • Loss of bowel or bladder control
  • Cold sensation in the hands, legs or feet
  • Loss of feeling in the legs
  • Muscle weakness or difficulty walking
  • Muscle spasms
  • Scoliosis
  • Paralysis

Spinal cord tumors that develop in people with a history of cancer are more common. Patients who have undergone treatment for cancer may be more rigorously screened for a spinal tumor than patients without a history of cancer. Although spinal cord tumors are often slow-growing, today’s advanced imaging options allow spinal cord tumors to be more quickly diagnosed than they were in the past.  

Types of Spinal Cord Tumor

There are three types of spinal cord tumors that can cause back pain and other symptoms.

  • Vertebral column tumors: This type of spinal cord tumor occurs in the vertebral column, growing from the bone or disc of the spine. These are most common in younger adults, are rare and typically grow slowly. When the vertebral column tumor originates in the spine (primary tumor), it is typically benign. However, if a vertebral column tumor is cancerous, it has typically metastasized (spread) from cancer in another area of the body. In women, these most frequently spread from cancer of the breast or lung. In men, they can spread to the spine from cancer of the prostate or lung.
  • Intradural-extramedullary tumors: Also rare and slow-growing, this type of spinal cord tumor grows inside the spinal canal, underneath the membrane covering the spinal cord but outside of the spinal nerves. Most commonly, these tumors are meningiomas, which are usually benign and occur in middle-aged to elderly women, or nerve sheath tumors that originate in the nerve roots coming off the spinal cord. Intradural-extramedullary tumors can cause symptoms of pain or weakness.
  • Intramedullary tumors: This type of spinal cord tumor grows inside the spinal cord or inside the individual nerves inside the spinal cord. They typically occur in the cervical spine, or neck, and are also usually benign. Spinal cord surgery to remove an intramedullary tumor may be difficult due to the nature of the tumor.

Spinal tumor surgery

After your doctor has run tests to determine whether the tumor is malignant or benign, he or she will discuss treatment options. In some cases, the tumor may be monitored to see if it disappears on its own. A spinal cord tumor may also be removed with spinal tumor surgery. The type of treatment often depends on the type of spinal cord tumor.

The goal of treatment of a vertebral column tumor that has developed from an advanced cancer in another part of the body is to control pain, preserve neurological function by removing pressure from the spinal cord and fix structural instability in the spine, typically through spinal fusion.

Intradural-extramedullary and intramedullary tumors are typically treated with spinal tumor surgery with the goal of complete removal of the spinal cord tumor and preservation of neurological function.

Spinal tumor surgery can be complex, as the spinal cord and spinal nerves are extremely sensitive. It is critical to select a surgeon who is experienced in the removal of spinal cord tumors.

The thought of a spinal cord tumor may be frightening, but it is important not to jump to conclusions. If you have back pain, it is more likely that your pain is caused by another back condition, such as back strain. Pain that does not improve over time may be due to a more serious cause, such as spinal cord tumor.

If you are experiencing long-lasting pain or other symptoms listed above, do not wait to schedule an appointment with a spinal doctor for diagnosis and treatment. Houston’s spine surgeon, Dr. Vivek Kushwaha, is experienced in diagnosing and surgical treatment of spinal cord tumors.

Make an appointment with Dr. Kushwaha for diagnosis and treatment. Make An Appointment