Spinal tumor: types of tumors, symptoms and complaints, treatment and removal surgery

Neoplasms localized in the spine are quite rare. Approximately 5% to 15% of all possible bone tumors are secondary and primary tumors of the spinal column and spinal cord. More than 50% of this type of disease is detected after the age of 40 years. They are more common in women than in men.

Schematic representation of the pathology.

Spinal lesions, represented by benign formations, develop slowly, therefore, as a rule, they do not particularly bother a person. If the benign tumor is aggressive, which happens in exceptional cases, the patient notes discomfort in the back, painful signs, movement disorders, problems with organs located near the pathologically changed area.

As for malignant neoplasms, they are very difficult and lead to loss of ability to work. Without timely detection of a complex clinical problem and adequate treatment, a person can quickly become disabled, and sudden death is not excluded.

Answers to frequently asked questions

An unfavorable focus can develop both in the lumbar region and sacrum, and in the cervical and thoracic areas of the spine. To this day, doctors cannot yet reliably say what specific causes lead to tumors affecting the lumbar and other segments of the spine. Read on about this and more.

Reasons for development

Despite the etiology that is not completely clear to science, experts suggest that vertebral tumors can form due to:

genetic predisposition;
unbalanced diet;
smoking and alcohol abuse;
influence of toxic substances on the body;
exposure to radioactive radiation;
immunodeficiency and autoimmune pathologies;
prolonged exposure to the sun, frequent visits to the solarium;
chronic diseases of the spine and its traumatic injuries;
prolonged and frequent stress.

ICD codes with interpretation

According to ICD 10, the classification of neoplasms of the vertebral system provides the following codes:

C41.2 – malignant neoplasm (MN) of the spinal column (except for the sacrum and coccyx, code C41.4),
D16.6 – benign neoplasm (BN) of the spine;
D18.0, D18.1 – hemangioma, lymphangioma of any location;
D32.1 – DN of the spinal cord membranes;
D33.4 – DN of the substance of the spinal cord;
D42.1 – tumor of the spinal cord of unknown nature;
C72.0 – ON of the spinal cord.

The International Classification of Diseases, 10th revision, where pathologies are assigned code values, allows specialists around the world to adhere to uniform treatment, diagnostic and rehabilitation standards, maintain statistical records of morbidity and mortality, and use codes in medical documents (in certificates, disability certificates, etc.).

Diagnostic methods

For diagnostic purposes, traditional visualization tools are used for these purposes. Many people are interested in whether a tumor in the spine is visible on an X-ray? Some tumor processes can be seen on X-rays, but to establish the type and stage of the tumor, more informative imaging techniques are used, in particular tomography methods (CT and MRI). Therefore, answering the question whether radiography shows all neoplasms, we answer that no, especially spinal ones. For complete information content, the following fundamental methods are used:

computed tomography;
magnetic resonance imaging;
scintigraphy.

MRI diagnosis of spinal column tumor.

A biopsy, blood and urine tests are always prescribed. Comprehensive diagnostics makes it possible to fully understand the exact etiology, localization, type, stage, nature, extent of pathology, its spread to distant places and the presence of metastases.

Metastatic tumors

What tumors metastasize? Let us answer right away that benign diseases do not give metastases. According to clinical observations, of all malignant diseases in the spine, approximately 96% are secondary tumors, the remaining 4% are primary. This suggests that the dominant number of cases are associated with metastases, that is, cancer cells that have migrated to the spine from the primary lesion, which originally originated in another organ.

The main sources that metastasize to various parts of the spinal column are breast, prostate, thyroid, bladder, kidney and lung cancer. In addition to biopsy procedures and tomographic examination, blood biochemistry for tumor markers will help to identify the presence of cancer, which can be used to determine the location of the primary lesion, its growth, and metastases. To make it clearer, let’s give an example of what blood shows in this case:

PSA enzyme > 30 units/ml – prostate cancer;
CA 15-3 > 30 units/ml – breast cancer;
the hormone calcitonin in men > 8.5 ng/l, in women > 5.1 – damage to the thyroid gland;
Tu M2-RK from 16 units/ml or more, SCC >2.5 ng/ml – kidney cancer is affected;
poor CEA values in combination with elevated CA 72-4 and CYFRA 21-1 – damage to lung tissue by cancer cells.

Metastatic tumor.

Thus, as you understand, a tumor may not necessarily initially originate in the spine. It can occur against the background of complications in the form of metastases, which have moved through the bloodstream or lymphatic vessels to the spinal region from completely different organs and systems in the body. At the same time, “maternal” tumors come in different types. Therefore, it is very important to use a differential approach to establish a true diagnosis.

As for primary neoplasms of a malignant nature, they arise in the ridge in isolated cases. In turn, they can also metastasize, but to other bones, liver, lungs, brain, lymph nodes, etc.

Metastases most often affect the lower thoracic and upper lumbar spine. Active malignant cells settled in them put pressure on the spinal cord, nerve endings, intervertebral discs, seriously reduce the density of the bone structure of the vertebral bodies, which is why neurological signs are clearly expressed and the likelihood of sudden compression fractures, spinal cord damage, increases significantly. death of nervous tissue.

Causes

There are two theories for the origin of osteomas: from the remnants of embryonic cartilage or from the periosteum of mature bone. In some cases, the occurrence of osteomas is associated with an inflammatory process or injury Source: Toropova I.A. Features of the clinical course of osteoma of the nose and paranasal sinuses / I.A. Toropova // Bulletin of RUDN University. — Medicine Series. - 2005. - No. 1(29). — P. 95-97. .

It is believed that the development of osteomas is also facilitated by:

injuries;
hypothermia;
inflammation and previous infections;
some diseases (rheumatism, gout, syphilis);
genetic predisposition.

Classification and general symptoms

Benign tumors of the lumbar, thoracic and cervical regions may not manifest themselves at all or cause minor local pain and slight stiffness of movement. Such formations usually do not progress at a rapid pace. But in any case, they require constant medical supervision. If they are small in size, they do not pose a critical threat to human performance and life. However, greatly overgrown pathological tissues are fraught with the development of dangerous consequences, including paralysis of the limbs. Large masses of benign nature provoke pain, disruption of the innervation of nearby organs, changes in the morphological parameters of osteochondral vertebral structures, etc.

Section of vertebrae with a neoplasm.

Tumors of a malignant nature manifest themselves clinically at an early stage, as they are characterized by rapid growth and rapid progression. We suggest you look at the photos to better imagine what they look like. Regardless of the cell class, the symptoms for all types of cancer are approximately the same. The first clinical symptom is pain within the affected area. It can be of a varied nature and of any intensity: aching, shooting, pulling, pressing, tightening, encircling, sharp, etc. In addition, painful signs quickly gain momentum, becoming stronger and brighter, especially during the infiltrating process, when strands of cells grow into neighboring structures or compress nerve roots and spinal cord.

For both types of neoplasms, in addition to the local pain factor, it is also common to cause symptoms such as:

feeling of weakness in the back;
sensory disorders in the legs or arms - numbness, coldness, crawling, weakness, burning, etc.;
pain in the lower or upper extremities;
dysfunction of the pelvic organs (problems with urination, defecation, potency, etc.);
problems with the cardiovascular system, brain;
paresis or paraplegia of a certain part of the body, more often one of the limbs (in advanced cases);
all kinds of spinal curvature (scoliosis, non-physiological kyphosis and lordosis).

We emphasize that none of the above signs without a thorough examination can clearly indicate the presence of a neoplasm. There are many ailments, including those of the spinal system, that manifest themselves in a similar way.

There can be no talk of any panic or any prescription of therapeutic measures until a high-quality diagnosis has been completed and an accurate diagnosis has been made. If you have the corresponding symptoms, you must contact a medical facility immediately!

Diagnostic methods

Today, there is a fairly wide range of methods for diagnosing cancer. These include the following:

preliminary examination by a doctor and palpation of the area of the spine affected by the tumor;
radiography is not a very effective technique, but often further examinations are carried out based on the X-ray;
CT scan;
Magnetic resonance imaging;
analysis of a tumor fragment for the presence of atypical cells.

Cervical lesion

The cervical region is the most dangerous place, because here the spinal cord passes into the brain, and there is also a large neurovascular line in the neck. And any pathology concentrated in this department poses a great threat not only to the spinal structures, but also to the components of the higher part of the central nervous system, namely the brain. In general, cancer in any other segment - thoracic and lumbosacral - is associated with its own risks and complications. Let's consider what symptoms can be observed during tumor processes that attack one or another department.

MRI of the cervical spine.

Symptoms of a cervical tumor

With neoplasms of the cervical spine, you may be concerned about:

constant or recurrent neck pain;
radiating pain to the arm;
stiffness of the neck muscles;
painful sensations between the right shoulder blade and the spine, in the jugular fossa;
dizziness, loss of consciousness;
nausea, lack of appetite;
problems swallowing;
lack of coordination;
impairment of vision and/or hearing;
headaches, discomfort in the head;
memory impairment, low concentration;
partial or complete failure of motor functions of the hand;
paralysis of the respiratory muscles is possible, up to respiratory arrest.

Common signs of a lumbar spine tumor:

regular pain in the lumbar region, often radiating to the buttock or thigh;
loss of leg strength, problems with movement, the skin on the leg may acquire a marbled tint (if treatment is not started in a timely manner, the limbs may completely fail);
spontaneous urination or uncontrolled bowel movements;
impotence, infertility, menstrual irregularities;
atrophy of the quadriceps (thigh muscle);
paresis of the lower legs, especially in the area of the ankle and ankle (in severe cases, paralysis of the legs is possible);
local tingling, numbness and other unpleasant sensations in the area of the sciatic nerve and in the legs.

Clinical manifestations in the thoracic region are expressed:

pain in the back, chest, ribs, upper abdomen;
disturbances in the functioning of the cardiovascular system (blood pressure surges, arrhythmia, tachycardia, etc.);
failure of the digestive system;
rapid fatigue during physical activity;
breathing problems, shortness of breath, shortness of breath;
an increase in pain when trying to take a deep breath, when coughing (if untreated, suffocation may occur; artificial ventilation is sometimes urgently needed);
complete or partial paralysis of those parts of the body that are located below the resulting lesion.

Types of benign tumors and their treatment

Known benign formations include:

hemangioma;
osteochondroma;
osteoid osteoma;
osteoblastoma;
eosinophilic granuloma;
aneurysmal bone cysts.

Vertebral hemangioma is one of the harmless vascular tumors of the spine that develops from endothelial cells. The prevalence ranges from 10% to 12.5%. It is formed mainly inside the spongy structure of the vertebra. As a rule, the thoracic (in 1st place) or lumbar regions are affected. Pathology of the cervical spine is the least frequently detected. In most cases, it does not behave aggressively, so treatment mainly consists of physical procedures and diagnostic monitoring. A large vascular conglomerate is subject to minimally invasive surgery using medical cement.

Osteochondroma is the most common pathology (up to 36%) and is a nodular outgrowth of bone tissue interspersed with calcified cartilage, which is covered on top with a smooth cartilaginous “cap.”
It is located on the surface of the bone, most often on the spinous processes. It mainly appears in children around the age of 10; the period of development of the pathological formation lasts 15-16 years. It is treated by marginal resection of the defective bone along with the exostosis pedicle. The prognosis for recovery is favorable. Osteochondroma of the spine on x-ray.
Osteoid osteoma is a small round bone tumor formed from osteoclasts.
Among all, DN occupies 10%-12%. The articular processes of the vertebrae and their posterior structures, mostly the arches, are usually affected. It mostly affects young males and teenage boys. The most common location is the lumbar region (in 60% of cases). The only method of combating the disease is surgery, which involves excision of the defect with adjacent sclerotic areas of the bone. The outcome of treatment is generally favorable. Osteoid osteoma on MRI.
Osteoblastoma is similar to osteoid osteoma, but is much larger in size.
Its other name is giant cell tumor. This is a very rare form of the disease (among DN - 1%). It is more common in young people; the majority of patients are people under 30 years of age. Men suffer from this disease 2 times more often than women. Severely mutated tissue feels like a foreign body in the spine. Treatment measures are similar to the previous problem. Osteoblastoma on MRI
Eosinophilic granuloma is an infiltrate consisting of macrophages that most often affects the vertebrae. A very rare group of DN with a poor clinical picture. The first symptoms are rapid fatigue, decreased mobility at the site of the lesion, and mild periodic pain during physical activity. Sometimes it can be asymptomatic, but in the absence of appropriate treatment it leads to various deformities of the spinal column, increased painful manifestations, muscle hypertonicity, and stiffness of gait. Therapeutic measures include unloading the spine and the use of painkillers. In advanced cases, intratumoral curettage and surgical decompression of the spinal cord are performed.
Aneurysmal bone cysts are bone cysts that are cavities in hard tissue filled with blood.
Often appears in the posterior segments of the vertebrae or directly in the vertebral body. The disease can develop after a spinal injury. The most common location is the cervical spine. Therapy consists of excision of the cystic element, curettage of the damaged area, and, if necessary, spinal decompression. Aneurysmal bone cysts

Types of malignant tumors

In this section we will look at malignant tumors of the spinal cord and spine, which are most often diagnosed. Below are brief characteristics of the most common pathologies of primary origin, that is, those that initially arise in the spinal column.

Chondrosarcoma - is formed from cartilaginous matter, concentrates on the vertebral arches, and over a short time spreads to adjacent vertebral structures and ribs (the most vulnerable area is the lumbosacral region);
Chondrosarcoma of the spine
Ewing's sarcoma is a childhood cancer that appears in the vertebrae and soft tissues of the spine, and is characterized by the highest degree of aggressiveness and rapid metastasis to the lymphatic structures, various parts of the skeleton and the lungs.
A spinal hematoma may form due to a tumor; treatment of this dangerous phenomenon will further complicate and worsen your well-being significantly. Ewing's sarcoma
Chordoma - is formed from the remnants of the notochord (embryonic cells that form the spine), while the main area of its location, as a rule, is the sacrococcygeal region;
Chordoma
Osteosarcoma is the most common form of malignant formations, accounting for 50% of all cancers.
It is formed from its own bone tissue, and often “gives” metastases. Spinal osteosarcoma
Reticulosarcoma is an accumulation of cancerous lymphocytes in the tissues of the spine, accompanied by acute neurological disorders, severe pain, and often fracture of the vertebrae.

ONs can be intramedullary, namely, those located directly in the spinal cord (identified extremely rarely). For example, a primitive neuroectodermal tumor developing from neural progenitor cells. Due to the specific localization of intramedullary forms, surgical intervention to remove the modified area of tissue is impossible. Extradural (bone) and extramedullary intradural (within the meninges) varieties have better prospects, as they are more accessible for removal. It is worth noting that this also applies to the benign nature of diseases.

Depending on the type, nature and location of the tumor, a further treatment plan is developed; the patient may be prescribed:

potent medications based on corticosteroids;
radiation therapy;
chemotherapy;
surgical removal of the tumor (if it is operable);
decompression and restoration-plastic operations in case of damage and compression of vertebral structures by a tumor object.

Cancer intoxication

Having considered each point, we can derive general patterns. Firstly, it becomes difficult for a person to move. In the final stages there may be complete paralysis. Secondly, a person constantly experiences fatigue, even if he did not work and got enough sleep. It is worth paying attention to sweating: if it is cold (and sticky), then this fact indicates a cancerous disease. The number of urges to go to the toilet increases. An upset stomach is diagnosed: frequent diarrhea.

Tumor near the spine: what is it?

Don’t look for photos on the Internet if you find some raised formation or compaction on your spine! You still cannot make a diagnosis on your own. All this is understandable, you are worried about your health and urgently want to find out what kind of pathology has appeared on your back, is it cancer? However, even an experienced doctor will not always be able to make a diagnosis right away, simply by examining or palpating the painful area. Visually recognizable tumors visible on the back are not always a terrible oncology, but even without a qualified examination there is no guarantee that it is not.

There are a great many variants of diseases that can be concentrated in one place or another along the spine. This may be a complicated degenerative-dystrophic pathogenesis, a non-malignant or cancerous tumor of the spinal system. Or some disease of completely different tissues, for example, subcutaneous fat (lipoma, atheroma, etc.).

For your own good, in order to find out the type, malignancy of the pathogenesis, and receive an effective treatment program from a specialist, you should immediately visit a medical facility and undergo the necessary comprehensive diagnostics. Delay in the presence of cancer can cost a person his life.

Prevention

There are no special preventive measures to prevent the occurrence of osteoma. Doctors recommend taking an x-ray every year to detect the tumor in a timely manner and, if necessary, remove it.

Specialists of the medical surgical department successfully perform operations to remove various types of osteomas. If you notice a lump on any bone, contact a specialist who will make a diagnosis and promptly prescribe treatment.

There is no special prevention for this disease. The main cause of osteomas is considered to be genetic predisposition.

Some recommendations:

avoid injury;
timely cure diseases of the musculoskeletal system;
undergo examination if any neoplasms of unknown origin are detected.

How is hemangioma treated?

A hemangioma of the vertebral body, if it is small in size and does not manifest itself aggressively, is not touched, but simply observed, periodically doing an MRI. This disease is benign, so there is no strong cause for concern; a tumor up to 1 cm is not dangerous. Usually it does not cause problems for a person, and if there are no signs of osteoporosis and neurological symptoms, treatment is limited to a maximum of exercise therapy and physiotherapy. But increased parameters of an abnormal vascular bundle inside the bone, which happens in isolated cases, require special surgical intervention. And primarily due to the fact that a vertebra affected by a defective conglomerate becomes fragile from the inside and can break at any time.

Hemangioma

In order to regress the tumor substance, as well as to reduce the neurological signs of the tumor and strengthen the weak vertebra, very productive neurosurgical technology is successfully used today. It's called vertebroplasty. This is a minimally invasive modern tactic that does not require general anesthesia and wide incisions. The essence of the technology is the introduction of bone cement based on polymethyl methacrylate through a percutaneous puncture into the pathological formation. The medicinal mixture is first mixed, after which a polymerization reaction occurs, releasing heat. Then the resulting mass is immediately fed through the working needle. The patient is allowed to go home within 24 hours after the intervention.

Rehabilitation after removal

After surgery, a patient is required to undergo a rehabilitation program to restore quality of life, prevent the development of complications and relapse of the disease. It is selected individually, based on the clinical case and the method of tumor removal. Therefore, the range of postoperative prescriptions for each individual patient will be different. It is worth noting that regardless of the type of surgical procedure involved, exercise therapy and physical therapy sessions are always recommended.

Recovery process.

It is extremely important for such complex patients to undergo both surgery and postoperative recovery in the conditions of the best medical center. Israeli, Czech and German clinics are highly professional in solving oncological spinal problems. I would especially like to highlight the Czech Republic, where the level of orthopedics, traumatology, oncology of the spinal system and rehabilitation management of cancer patients is similar to Israel and Germany, and the cost of equivalent high-tech care is two times lower.

But that’s not all, on the territory of the Czech Republic there are the best sanatoriums for spinal oncology, which, without exaggeration, have no equal in the whole world. Among the world-famous spa areas, where the most successful highly specialized sanatoriums operate, Karlovy Vary, Frantiskovy Lazne, Janske Lazne are especially popular. Today, the medical company Artusmed has earned high trust among domestic patients, which professionally and conscientiously helps organize treatment in the Czech Republic, a state where only modern and only promising methods of antitumor therapy of the spine have been mastered and practiced at an advanced level.