A vertebral tumor is a type of spinal tumor affecting the bones or vertebrae of the spine. Spinal tumors that begin within the spinal cord or the covering of the spinal cord (dura) are called spinal cord tumors.
Tumors that affect the vertebrae have often spread (metastasized) from cancers in other parts of the body. But there are some types of tumors that start within the bones of the spine, such as chordoma, chondrosarcoma, osteosarcoma, plasmacytoma and Ewing’s sarcoma.
Tumors that begin in the bones of the spine (primary tumors) are far less common. Plasmacytoma is one type of primary vertebral tumor.
Other tumors, such as osteoid osteomas, osteoblastomas and hemangiomas, also can develop in the bones of the spine.
Vertebral tumors can cause different signs and symptoms, especially as tumors grow. The tumors may affect your spinal cord or the nerve roots, blood vessels, or bones of your spine. Vertebral tumor signs and symptoms may include:
Pain at the site of the tumor due to tumor growth
Back pain, often radiating to other parts of your body
Back pain that’s worse at night
Loss of sensation or muscle weakness, especially in your arms or legs
Difficulty walking, sometimes leading to falls
Feeling less sensitive to cold, heat and pain
Loss of bowel or bladder function
Paralysis, which may be mild or severe, and can strike in different areas throughout the body
Spinal tumors progress at different rates depending on the type of tumor.
The goals of treatment for metastatic spinal tumors are generally:
Curative in oligometastatic disease
Palliative treatments designed to optimize the patient’s quality of life, and to minimize pain and disability, including:
Preservation of neurological function
Prevention of fracture
Correction of spinal instability
Improvement of the patient’s general functionality and ability to move/walk
Support the patient’s ongoing cancer treatments that are designed to bring the cancer into remission or to prolong the patient’s life
Debulk, or shrink, the spine tumor to decrease the tumor burden
In general, earlier diagnosis and treatment of spinal tumor symptoms result in a better outcome. Cancer patients who experience development of new symptoms of back pain and/or limb neurogical symptoms should seek immediate medical care.
Treatment options for most vertebral tumors include:
Some tumors may be discovered before they cause symptoms — often when you’re being evaluated for another condition. If small tumors are noncancerous and aren’t growing or pressing on surrounding tissues, watching them carefully may be all that’s needed.
This is often the treatment of choice for tumors that can be removed with an acceptable risk of spinal cord or nerve injury.
Newer techniques and instruments allow neurosurgeons to reach tumors that were once considered inaccessible.
But even with advances in surgical techniques and technology, not all tumors can be totally removed. Sometimes, surgery might be followed by radiation therapy, chemotherapy or both.
Recovery from spinal surgery may take weeks or longer, depending on the procedure or complications, such as bleeding and damage to nerve tissue.
Radiation therapy.This may be used following an operation to eliminate the remnants of tumors that can’t be completely removed, treat inoperable tumors or treat those tumors where surgery is too risky.It may also be the first line therapy for some vertebral tumors. Radiation therapy may also be used to relieve pain when surgery is too risky.
Stereotactic radiosurgery (SRS).This treatment, which isn’t actually surgery, delivers a high dose of precisely targeted radiation. In SRS, doctors use computers to focus radiation beams on tumors with pinpoint accuracy and from multiple angles.
A standard treatment for many types of cancer, chemotherapy uses medications to destroy cancer cells or stop them from growing. Your doctor can determine whether chemotherapy might be beneficial for you, either alone or in combination with other therapies.
Thermal and non-thermal ablation therapies
Vertebral metastases tumor RFA is a palliative treatment because they may cause intolerable pain by a number of different mechanisms.
Over the last decade, the effectiveness of radiofrequency ablation in reducing pain associated with benign osseous tumors as well as bone metastasis has been documented. The idea behind the procedure is to address the mass-related pain generators by ablating the tumor and at the same time providing access for cement implantation into the weakened and often fractured vertebral body.