Spinal Cord Tumor

Diagnosis

To diagnose a spinal cord tumor, a healthcare professional usually begins by asking about your symptoms and medical history. A physical examination is done to understand how well your nerves are functioning. Imaging tests and, in some cases, a biopsy are used to confirm the diagnosis and determine the type of tumor.

A physical exam may include checking your back for areas of pain or tenderness and looking for other concerning signs. This exam often includes a neurological assessment to evaluate how your nervous system is working. Tests may focus on balance, coordination, muscle strength, reflexes, and sensation.

Magnetic resonance imaging is the most commonly used test to diagnose spinal cord tumors. MRI uses a strong magnetic field and radio waves to create detailed images of the spinal cord and surrounding structures. A spinal MRI is usually the preferred imaging test because it provides clear and detailed views of soft tissues.

During the MRI, a contrast dye may be injected into a vein in your hand or arm. This dye helps highlight abnormal areas and makes tumor tissue more visible on the images.

A computerized tomography scan uses X-rays and computer processing to create detailed cross-sectional images of the spine. A spinal CT scan can show bone and structural details clearly. Sometimes a contrast dye is used to improve image clarity. CT scans are not typically the primary test for spinal cord tumors, but they may provide additional information in certain situations.

A biopsy may be needed to confirm the diagnosis. A biopsy involves removing a small sample of tissue so it can be examined in a laboratory. Testing the sample helps determine the exact type of spinal cord tumor.

In some cases, a needle is guided through the skin into the spine to collect a tissue sample from the tumor. The sample is then sent to a lab for analysis, which helps the healthcare team plan appropriate treatment.

Often, a biopsy is performed during surgery. The tissue may be examined immediately while surgery is in progress. These results can help the surgeon decide how much of the tumor can be safely removed.

Treatment

The main treatment for a spinal cord tumor is surgery. In some situations, radiation therapy or chemotherapy may also be part of the treatment plan.

The primary goal of treatment is to remove the spinal cord tumor completely when possible. However, complete removal may not always be safe because of the risk of damaging the spinal cord or nearby nerves. For this reason, treatment planning is done carefully.

When developing a treatment plan, the healthcare team considers several factors, including the tumor type, its location within the spine, whether it involves the spinal cord or surrounding tissues, your overall health, and your personal preferences.

Some spinal cord tumors do not cause symptoms. If a tumor is small, growing slowly, and not affecting nerve function, immediate treatment may not be necessary. Instead, the healthcare team may monitor the tumor closely.

Monitoring may involve regular imaging tests to watch for changes in tumor size or behavior. Treatment can begin if the tumor shows signs of growth or starts causing symptoms.

Surgery aims to remove as much of the spinal cord tumor as possible. Doctors carefully evaluate whether surgery can be performed without causing permanent nerve damage. If the risks are acceptable, surgery may be recommended.

During surgery, the surgeon usually makes an incision in the back or neck to reach the spine. Portions of spinal bone may be removed to access the spinal cord. Using high-powered microscopes and specialized instruments, the surgeon carefully removes the tumor.

During some procedures, surgeons monitor nerve function in real time. This helps reduce the risk of nerve injury. Advanced techniques, including the use of high-energy sound waves to break up tumor tissue, can make removal safer and more effective.

Despite advances in surgical techniques, some spinal cord tumors cannot be completely removed. In these cases, as much of the tumor as possible is taken out, and additional treatments may be recommended afterward.

Recovery from spinal surgery can take weeks or months, depending on the extent of the procedure. Temporary changes in sensation or movement are common after surgery and may improve gradually. Long-term recovery depends on individual factors and should be discussed with your healthcare team.

Radiation therapy uses powerful energy beams, such as X-rays or protons, to destroy tumor cells. During treatment, you lie on a table while a machine directs radiation precisely to the affected area.

Radiation therapy may be used after surgery to destroy remaining tumor cells. It may also be used as the main treatment if surgery is not possible or risky.

Chemotherapy uses strong medicines to treat cancer. These medicines are usually given through a vein, although some are taken by mouth.

Chemotherapy is not effective for all spinal cord tumors. It is more commonly used for fast-growing tumors, including certain spinal cord cancers. In some cases, chemotherapy is given after surgery to help eliminate any remaining tumor cells.