Spinal Tumors

Overview

Spinal tumors can develop in different ways. Primary spinal tumors start in the spinal tissue and nerves or the bones of the spinal column. Metastatic tumors originate from somewhere else in the body. They can start as lung cancer, breast cancer or colon cancer and spread (metastasize) to your spine. In some cases, genetic diseases cause primary spinal tumors. In most cases, physicians do not know the cause of primary spinal tumors.

Spinal Tumor Types

• Chordomas: Types of tumors that develop in the bones or vertebrae of the spine. They can form anywhere along your spine, but most commonly form in the base of the spine. They develop from cells once part of the embryonic notochord in utero.
• Osteosarcomas: Types of bony, spinal tumors. These cancerous tumors often appear in adolescence or in adults over the age of 60. They tend to develop in bones that are growing rapidly during adolescence, such as the long bones of your legs and your spine.
• Ependymomas: Spinal tumors that occur in the nerves of the spinal cord itself. They occur most frequently in children and rarely in adults.
• Schwannomas: Tumors in the tissues that cover the nerves, called Schwann cells. They tend to be benign (noncancerous) and often develop in the nerves of the head and neck or the nerves that control the arms and legs.

Symptoms

• Weakness in the arms and legs
• Difficulty walking
• Abnormal sensations in the arms and legs
• Back pain
• Urinary and/or fecal incontinence
• Loss of muscle function
• Muscle contractions or twitching

Treatment

The complexity of spinal tumors, whether cancerous or not, demands special care. At the Indiana University Health Neuroscience Center, your physician will use a collaborative approach to determine the best treatment for you. Experts include:

• Neurologists
• Neurosurgeons
• Neuro-oncologists
• Neuropathologists
• Neuropsychologists
• Neuroradiologists

Your physicians will work with the IU School of Medicine and Riley Hospital for Children at IU Health to deliver specialized, individualized care and leading-edge research. Your physicians will offer comprehensive neurological services at Riley Hospital for Children at IU Health including our neurofibromatosis clinic, the only one of its kind in the state.

IU Health researchers conduct leading-edge investigations into adult and pediatric spinal tumors and offer state-of-the-art treatments that deliver targeted doses of radiation. In addition, your physicians will use the latest surgical techniques to personalize and deliver the best care options available for you.

The specific treatment for your spinal tumor depends on its type, location, size and rate of growth. Treatments generally include:

• Corticosteroids
• Radiation
• Chemotherapy
• Surgery

To deliver the best outcomes, IU Health physicians will perform comprehensive diagnostic tests to fully understand your condition. Your treatment plan will follow and may include medicines, neurosurgery, radiation and chemotherapy. Diagnostic tests and treatments may include:

• Neurological exam
• Diagnostic tests. Your physician may use a variety of imaging and other tests to locate, diagnose and monitor your tumor during treatment. These tests may include:
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT)
  • Positron emission tomography (PET) scans
  • Single Photon Emission Computed Tomography (SPECT) is an imaging test that shows blood flow patterns to different tissues. It can help to identify tumors that grow new blood vessels.
  • Laboratory tests examining your blood and urine will provide more information about your tumor.
  • Electroencephalograms (EEG)
• Medicines. Your physician may prescribe a variety of medicines to treat symptoms related to your spinal tumor. These can include anticonvulsants to reduce seizures, pain relievers, anti-inflammatory drugs to reduce swelling, and anti-depressants for anxiety and depression.
• Neurosurgery:
  • Intraoperative MRI scanners allow your neurosurgeon to perform more precise operations.
  • The Zeiss OPMI Pentero is a neurosurgery microscope that uses intraoperative florescence to give your surgeon a clearer picture of blood vessels.
  • The NICO Myriad device is used to remove hard-to-reach spinal tumors.
• Radiation therapy:
  • Gamma knife
  • Novalis-Shaped beam surgery
• Chemotherapy
• Research. Researchers actively investigate treatments with clinical trials sponsored by the National Institutes of Health for brain tumors.