Introduction to Spinal Tumours

Spinal tumours are abnormal cellular growths that develop within the spinal column or the surrounding tissues. The spinal tumours can be benign (non-cancerous) or malignant (cancerous) and arise from various cell types, including bone, nerve, and soft tissue. Understanding the different types of spinal tumours, their causes, and their associated symptoms is crucial for early detection and effective treatment.

Understanding the Different Types of Spinal Tumours

Spinal tumours can be classified into several categories based on their location and the type of cells involved:

• Intradural-extramedullary Tumours: These tumours develop within the dura mater (the spinal cord's outermost layer) but outside the spinal cord itself. Examples include meningiomas and schwannomas.
• Intramedullary Tumours: These tumours originate within the spinal cord, often from the glial cells or the ependymal cells lining the central canal of our spinal cord. Examples include ependymomas and astrocytomas.
• Extradural Tumours: These tumours develop outside the dura mater, within the vertebral column or surrounding soft tissues. Examples include metastatic tumours, myelomas, and chordomas.

According to the origin, another classification of spinal tumour is:

• Primary Bone Tumours: These tumours arise from the bones of the spinal column, such as osteosarcomas, chondrosarcomas, and Ewing's sarcomas.
• Secondary Bone Tumours: A secondary bone tumour arises when cancer cells metastasise from another organ to the bones from a primary bone tumour.

Understanding the specific type of spinal tumour is essential for determining the suitable treatment approach and prognosis.

Common Causes of Spinal Tumours

The exact causes of spinal tumours are not fully understood, but several factors may increase the possibility of developing these growths, such as:

• Genetic Factors: Certain genetic ailments, such as neurofibromatosis and von Hippel-Lindau disease, can predispose individuals to developing spinal tumours.
• Environmental Exposures: Exposure to certain chemicals, radiation, or other environmental factors may contribute to the development of spinal tumours.
• Metastatic Spread: Spinal tumours can also develop as a result of the spread of cancer from other parts of the body, such as the lungs, breast, or prostate.
• Underlying Medical Conditions: Certain medical conditions, such as Paget's disease of the bone, may elevate the risk of developing spinal tumours.

Recognising the Signs and Symptoms of Spinal Tumours

The symptoms of spinal tumours can vary and depend on the location and size of the tumour, as well as the type of cells involved. Some common signs and symptoms include:

• Back Pain: Spinal tumours can cause persistent or worsening back pain, which may be localised to the site of the tumour or radiate to other areas.
• Neurological Symptoms: Tumours that affect the spinal cord or nerve roots can lead to various symptoms, such as numbness, tingling, weakness, or loss of sensation in the affected limbs.
• Gait Disturbances: Spinal tumours that compress the spinal cord can cause difficulties with walking, balance, and coordination.
• Bowel and Bladder Dysfunction: Tumours that affect the lower region of the spinal cord may cause bowel and bladder control problems.
• Muscle Atrophy: Compression of the spinal cord or nerve roots can result in muscle wasting or atrophy in the affected areas.
• Paralysis: A tumour may compress different nerves in different parts of your body, resulting in varying degrees of paralysis.

Diagnosing Spinal Tumours

Diagnosing spinal tumours involves a combination of medical history, physical examination, and various imaging tests. Some of the common diagnostic procedures include:

• Imaging Tests:

 A. Magnetic Resonance Imaging (MRI): An MRI is the primary imaging modality used to evaluate the spinal cord and surrounding structures, providing detailed information about the location, size, & characteristics of the tumour.

 B. Computed Tomography (CT) Scan: CT scans can help visualise the bony structures of the spine and identify any abnormalities or changes in the vertebrae.

 C. Positron Emission Tomography (PET) Scan: PET scans can assess the metabolic activity of the tumour and help differentiate between benign and malignant growths.

• Biopsy: In some cases, doctors may conduct a biopsy to obtain a tumour sample for further analysis and to confirm the diagnosis.
• Neurological Examination: A comprehensive neurological examination, including testing of reflexes, sensation, and muscle strength, can help identify any neurological deficits associated with the spinal tumour.

Treatment Options for Spinal Tumours

The treatment of spinal tumours depends on various factors, including the type of tumour, its location, the patient's overall health, and any neurological symptoms. The main treatment options include:

• Observation: For some small, slow-growing, and asymptomatic spinal tumours, a "wait-and-see" approach may be recommended, with regular monitoring through imaging tests.
• Radiation Therapy: Radiation therapy, either in isolation or in combination with other treatments, can be used to shrink or control the growth of spinal tumours.
• Chemotherapy: Chemotherapy may be used, particularly for malignant spinal tumours, to kill or slow the growth of cancer cells.
• Targeted Therapies: In some instances, newer targeted therapies, such as immunotherapy or molecularly targeted drugs, may be used to treat spinal tumours.
• Surgical Intervention: Doctors may recommend surgery for larger, symptomatic, or rapidly growing spinal tumours. The goal of surgery is to remove the tumour, decompress the spinal cord, and stabilise the spine. Surgical treatment for spinal tumours may involve one or more of the following procedures:

1. Laminectomy: This procedure involves the removal of a small portion of the vertebral bone (lamina). This gives the surgeon access to remove the spinal tumour.
2. Vertebrectomy: In this surgery, the entire affected vertebra is removed, and the spine is stabilised with spinal instrumentation, such as rods and screws.
3. Embolisation: Before surgery, the surgeon may perform an embolisation procedure to block the blood supply to the tumour, reducing the risk of bleeding during the operation.
4. Spinal Fusion: In some cases, a spinal fusion may be necessary to stabilise the spine after tumour removal, mainly if the tumour has caused significant damage to the vertebral bones.

Rehabilitation and Recovery After Spinal Tumour Treatment

After spinal tumour treatment, patients may require a comprehensive rehabilitation program to help them regain strength, mobility, and independence. This program may include:

• Physical Therapy: Exercises help improve muscle strength, flexibility, and coordination and address any neurological deficits.
• Occupational Therapy: Assistance with daily living activities, such as dressing, bathing, and using assistive devices.
• Speech and Swallowing Therapy: This therapy is for patients with tumours in the cervical (neck) region or at the base of the skull, which can impact swallowing and speech.
• Psychological Support: Counselling and support can help patients cope with the emotional & psychological aspects of their diagnosis and treatment.

Support and Resources for Individuals with Spinal Tumours

Navigating the diagnosis and treatment of a spinal tumour can be a challenging and overwhelming experience. However, there are various support resources and organisations available to help individuals and their families:

• Patient Support Groups: These groups provide a platform for individuals with spinal tumours to connect with others, share experiences, and receive emotional support.
• Educational Resources: Reputable organisations and doctors often offer informative materials and educational programs to help patients and their families understand spinal tumours and the available treatment options.
• Caregiver Support: Resources and support services are also available for the caregivers of individuals with spinal tumours, as they play a crucial role in the patient's well-being and recovery.

Conclusion 

Spinal tumours are complex and diverse growths that can significantly impact an individual's physical and emotional well-being by affecting mobility, sensation, and vital functions. Understanding the different types of spinal tumours, their causes, and the associated symptoms is crucial for early detection and effective treatment.

Research & advances in medical technology continue to improve the prognosis for patients with spinal tumours, highlighting the importance of holistic care & early intervention. Comprehensive rehabilitation and support resources are available to help patients & their families navigate the challenges of a spinal tumour diagnosis and treatment.

FAQs

What are the most common types of spinal tumours? 

The most common types of spinal tumours include intradural-extramedullary tumours, intramedullary tumours, and extradural tumours. The most common variants of spinal tumours are meningiomas, schwannomas, ependymomas, and metastatic tumours.

Can spinal tumours be prevented? 

While the exact causes of spinal tumours are not fully understood, there are no known preventive measures that can eliminate the risk. However, maintaining a healthy lifestyle, avoiding known risk factors, and undergoing regular check-ups can help reduce the likelihood of developing a spinal tumour.

How do spinal tumours differ in children and adults? 

Spinal tumours in children are more likely to be intramedullary (within the spinal cord) and often involve different cell types, such as astrocytomas and ependymomas. In adults, spinal tumours are more commonly extradural or intradural-extramedullary and are more likely to be metastatic.

What is the prognosis for individuals with spinal tumours? 

The prognosis for individuals with spinal tumours can vary greatly and depend on the type of tumour, its location, the extent of the disease, and the individual's response to treatment. In general, benign spinal tumours have a better prognosis than malignant ones. Early detection & correct treatment can significantly improve the chances of a positive outcome.

How can I support a loved one with a spinal tumour? 

Supporting a loved one with a spinal tumour can involve a series of actions, such as:

• Educating yourself about the condition & treatment options
• Accompanying them to medical appointments and treatments
• Offering emotional support and a listening ear
• Assisting with daily tasks and household responsibilities
• Encouraging them to participate in rehabilitation and support programs
• Connecting them with relevant support groups and resources