What are spinal tumors?

Updated: Nov 01, 2018
  • Author: Andrew A Sama, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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Answer

Primary spinal tumors fall into a distinct category because their timely diagnosis and the immediate institution of treatment have an enormous impact on the patient's overall prognosis and hope for a cure.

Generally, with spinal pathology, problems that arise are either chronic problems related to degenerative disease or deformity or acute manifestations of traumatic sequelae. When considering tumors of the spine, one must consider the different tissue types around the spinal column. The presence of neural tissue, meningeal tissue, bone, and cartilage makes any of these tissue types a possible nidus for neoplastic change. Also, metastatic lesions may spread to the spine from distant primary tumor sites by hematogenous or lymphatic routes.

Primary nonlymphoproliferative tumors of the spine are uncommon and make up fewer than 5% of bone neoplasms; the annual incidence of primary spine tumors is in the range of 2.5-8.5 per 100,000 population. Metastatic disease of the spine is much more common. Approximately 40-80% of patients who die of cancer have bony metastases at the time of death, with the spine being the most common metastatic skeletal location.

Neoplastic disease, however, can present with back pain that is indistinguishable from back pain resulting from more benign causes. Therefore, the physician caring for patients complaining of back pain is faced with the challenges of (1) distinguishing benign causes from those that can be neurologically or systemically devastating and (2) prescribing the appropriate treatment.

This distinction sometimes can be difficult to make because of the complicated architecture of the spine (see Anatomy). The physician must consider differential diagnoses of degenerative processes, infections, muscular strains, neurologic impingements, and, finally, neoplastic processes. With thorough history taking, physical examination, and diagnostic imaging, the physician can acquire enough information to make the correct diagnosis in an efficient manner. [1]


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