- Matthew J. Geck MD is a board certified, fellowship trained orthopedic surgeon who has a practice focused exclusively on spine and scoliosis surgery.
Types of Spinal Tumors
Vertebral Column Tumors:
Tumors that originate in the brain or spinal cord are called primary tumors. Primary tumors are extremely rare and slow growing. They occur in the vertebral column and develop from the bone or disc elements of the spine. Primary tumors more often occur in younger adults. The most common malignant bone tumor is the osteogenic sarcoma or osteosarcoma.
Primary bone tumors in the spine are very rare. The majority of spinal tumors are metastases. Of the sarcomas (meaning cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective tissue) found in the body only 10% occur in the spine. CDC US Cancer statistics taken from the 2000 incidence report show the occurance to be between 2.5% and 8.5% per 100,000 people.
Metastatic spinal tumors
The more common type of spinal tumor is the metastatic tumor. The most common site of bony metastasis is the spine, nearly 20,000 new cases develop per year.1 Metastatic tumors occur when cancer spreads from another area of the body. Women more often develop metastatic spinal tumors from cancer originating in the breast or lung. While men are more likely to develop a spinal tumor from cancer originating in the prostate or lung. Symptoms of metastatic tumors include pain that does not get better with rest and may be worse at night. These symptoms may be accompanied by other signs of serious illness, including weight loss, fever or chills, nausea or vomiting.
New developments in oncology have resulted in cancer patients living longer. In turn, there has been an increase of metastatic tumors which cause pain, spinal fractures, spinal cord compression and other instabilities. Surgery may be necessary in some cases to help manage the pain and restore function. Nearly two thirds of the lesions that develop are often hypervascular, meaning a large number of blood vessels are present. The risk for life-threatening hemorrhage during the open surgery is increased because of this.
These are tumors that occur in the spinal canal, below the membrane that covers the spinal cord. These spinal tumors occur outside of the nerves. Intradural-Extramedullary tumors are non-malignant and slow growing. They may cause pain symptoms and weakness. The majority of intradural - extramedullary tumors are either meningiomas or nerve sheath tumors.
These are spinal tumors that occur in the membranes surrounding the spinal cord. Meningiomas are typically benign but may be malignant. They are more common in middle age and elderly women.
Nerve sheath tumors
Spinal tumors that develop from the nerve roots that come off the spinal cord are known as nerve sheath tumors. This type of tumor (schwannomas and neurofibromas) is commonly benign and slow to spread. It can take years before a neurological problem is revealed.
These tumors develop from inside the spinal cord or inside the nerves. They occur from the cells that provide physical support and insulation for the nervous system also known as glial cells. Intramedullary tumors are more likely to develop in the cervical spine or neck. Intramedullary tumors are usually benign, while surgery to remove the tumor is complex. Intramedullary tumors are most commonly either astrocytomas or ependymomas.
1. Gokaslan ZL: Spine surgery for cancer. Curr Opin Oncol 1996;8(3):178-181.
2. "Preoperative Embolization in the Treatment of Spinal Metastasis" Truumees et al. J Am Acad Orthop Surg.2010; 18: 449-453