Vertebral Tumor

Diagnosis

Diagnosis for vertebral tumors usually begins with a physical examination and a review of symptoms. Imaging tests help determine the size and location of the tumor, and a biopsy confirms the diagnosis by testing a tissue sample in the lab.

Exams

A healthcare professional starts by asking about symptoms and medical history. It’s important to mention any current or past cancer, as most vertebral tumors result from cancer that has spread to the spine. The physical exam often includes checking for pain or tenderness along the spine and performing a neurological exam. This exam tests balance, coordination, strength, and reflexes to assess how nerves are functioning.

Imaging Tests

Imaging tests create detailed pictures of the spine and surrounding structures, helping determine the tumor’s size, location, and impact. Common imaging tests include:

• X-ray

• MRI

• CT scan

• Positron emission tomography (PET) scan

Biopsy

A biopsy involves removing a small tissue sample from the tumor for lab testing. In most cases, a thin needle is guided through the skin into the tumor using imaging such as a CT scan. The biopsy sample is then tested to determine whether the tumor is cancerous and what type it is.

Determining the best type of biopsy and performing it safely requires careful planning. The procedure must be done in a way that won’t interfere with future surgery to remove the tumor. For this reason, it’s recommended to seek a healthcare team with extensive experience in vertebral tumor treatment before undergoing a biopsy.

Treatment

Treatment for vertebral tumors depends on the type, size, and location of the tumor, as well as overall health and personal preferences. Options may include surgery, radiation therapy, chemotherapy, targeted therapy, or minimally invasive procedures. In some cases, monitoring without immediate treatment may be appropriate.

Careful Monitoring

Some vertebral tumors are found incidentally before causing symptoms. These may not require immediate treatment. Instead, regular monitoring may be recommended to track tumor growth over time. This approach is suitable for small, noncancerous, or slow-growing tumors that aren’t causing symptoms.

Surgery

The goal of surgery is to remove as much of the vertebral tumor as possible while protecting the spinal cord and nerves. In some cases, complete removal may not be possible. When this happens, surgery may be followed by other treatments such as radiation therapy, chemotherapy, or ablation to destroy remaining tumor cells. Surgery may also be used to relieve pain or pressure on the spinal cord caused by the tumor.

Vertebroplasty

Vertebroplasty involves injecting bone cement into a weakened or cracked spinal bone to stabilize it. A similar procedure, kyphoplasty, may also be used. These procedures help strengthen bones affected by tumors and relieve pain.

Ablation Treatments

Ablation treatments target tumor cells directly. Techniques include:

• Radiofrequency ablation or microwave ablation, which use heat to destroy tumor cells.

• Cryoablation, which uses extreme cold.

• Alcohol ablation, which uses alcohol to damage tumor cells.

These methods can help reduce pain or shrink tumors, especially when surgery isn’t an option.

Radiation Therapy

Radiation therapy uses powerful energy beams such as X-rays or protons to target and destroy tumor cells. It may be used after surgery to kill any remaining cells or as a primary treatment when surgery isn’t possible. Radiation therapy can also help slow tumor growth and relieve pain.

Advanced techniques like stereotactic body radiotherapy (SBRT) and proton beam therapy allow precise targeting of the tumor while minimizing radiation exposure to nearby organs and the spinal cord.

Chemotherapy and Other Medicines

Chemotherapy uses strong medicines to destroy cancer cells and may be recommended for cancerous vertebral tumors. Noncancerous tumors typically do not respond to chemotherapy.

Targeted therapy may also be an option. This treatment uses medicines designed to attack specific molecules within cancer cells, blocking their growth and causing them to die. Cancer cells are often tested to determine whether targeted therapy is likely to be effective.

These diagnostic methods and treatment approaches aim to manage vertebral tumors effectively, relieve symptoms, and improve overall quality of life.