Prompt diagnosis is crucial in treating a spine tumor. Determining whether
the tumor is malignant or benign, identifying its source, and finding
the total number of lesions will play a part in prognosis.
Patients with no history of cancer will receive a thorough physical exam,
usually from their primary care doctor, to investigate the cause of their
Symptoms of a Spinal Tumor). The primary care physician will often refer a patient for imaging studies
to help identify the source of the pain. Patients with a history of cancer,
or in current treatment for cancer, will likely be diagnosed by their
oncologists, also after imaging tests.
In addition to X-rays, the most common tests used to identify and diagnose
a spinal tumor include:
Magnetic resonance imaging (MRI): An MRI uses magnetic fields and radio-frequency waves to create an image
of the spine, and can reveal fine details of the spine, including tumor
growth. An MRI scan can show details in the spine that can’t normally
be seen on an X-ray. MRIs, which can show the softer tissues, can detect
disease tumor earlier than X-rays and CT scans. Sometimes a contrast agent
is injected into a vein in the hand or arm during the test, which highlights
certain tissues and structures to make tumor identification clearer.
Computerized tomography (CT): This test uses a narrow beam of radiation to produce detailed images of
your spine. Like the MRI, sometimes a contrast agent is injected into
a vein in the hand or arm during the test, which highlights certain tissues
and structures to make tumor identification clearer.
Myelogram: This test uses a dye that is injected directly into the spinal column,
and is used in conjuction with an X-ray, MRI, or CT scan.
Biopsy: Once the tumor is located, a biopsy will be taken to determine if the
cells are cancerous or benign. A doctor will insert a long, thin needle
into the growth to withdraw a few cells, or sometimes the cells are taken
during the actual surgery to remove the tumor. The cells are then studied
under a microscope and identified as either malignant or benign. If the
cells are cancerous, the tumor will be graded 1-4 for its aggressiveness,
and the medical team will develop and recommend a treatment plan.
The course of treatment depends on the type and location of the tumor,
and should be discussed in detail with your care team. Some treatment
Monitoring: If the tumor has been deemed non-cancerous, and is not growing or spreading,
then monitoring may be all that is needed.
Radiation Therapy: Chemotherapy is most often used when the cancer occurs in other areas
in the body in addition to the spine. Radiation is often used following
spine surgery, to ensure that all the cancer cells are eliminated that
may not have been possible during surgery. Sometimes radiation is used
in place of surgery.
Stereotactic Radiosurgery (SRS): Neurological surgeons can use stereotactic radiosurgery (highly targeted
radiation beams from multiple angles) to treat spinal tumors. This technique
is a highly effective and minimally invasive treatment. Side effects are
usually moderate and limited and the procedure carries a very low risk
of infection or other complications that can occur after open surgery.
This is a rapidly developing technique, requiring the most highly trained
surgeons utilizing the most sophisticated equipment – such as the
Gamma Knife, CyberKnife, proton beams, and linear accelerators –
and is usually only available in major medical centers (see
Doctors Who Treat Spinal Tumors).
Surgery: Removal of the mass via surgery may be the best option to not only remove
the growth but also relieve the pressure it’s putting on the spine
and nerves. Surgery often occurs in conjunction with radiation therapy.
(Read more about
Surgery for Spinal Tumors.)
Newest Techniques: Neurosurgeons at the Weill Cornell Brain and Spine Center are pioneering
new methods of radiation combined with surgery called brachytherapy with
Spine tumors are serious and complex lesions, and they should be evaluated
by experienced spine surgeons and spinal oncologists at a major medical
center. At Weill Cornell, our Spinal Tumor Program provides expert multidisciplinary
care for patients with both primary and metastatic spine tumors, as well
as access to advanced stereotactic radiosurgery options and new clinical trials.
Request an Appointment