Spinal Cord Tumor
A spinal cord tumor is an abnormal growth that develops within or around the spinal cord, the bundle of nerves that carries signals between the brain and the rest of the body. Spinal cord tumors may be benign or malignant and can arise from the spinal cord itself, the surrounding membranes, nearby nerve roots, or adjacent vertebral structures. Because the spinal cord sits within a narrow spinal canal, even relatively small tumors can cause important neurological symptoms by compressing the cord or nearby nerves.
What is it?
Spinal cord tumors are abnormal growths that develop within or around the spinal cord and spinal canal. They are generally classified according to their location relative to the spinal cord and its protective coverings.
Intramedullary tumors arise within the spinal cord itself. The most common types include ependymomas, astrocytomas, and hemangioblastomas.
Intradural-extramedullary tumors develop within the dura (the protective covering surrounding the spinal cord) but outside the spinal cord tissue. Common examples include meningiomas, schwannomas, and neurofibromas.
Extradural tumors occur outside the dura, usually involving the vertebrae or epidural space, and are commonly related to metastatic cancer spreading from another part of the body.
Spinal cord tumors may be primary tumors that originate within the spinal canal or secondary tumors that spread from cancers elsewhere in the body. Some tumors are associated with inherited syndromes such as neurofibromatosis or von Hippel–Lindau disease, which increase the risk of developing multiple tumors over time.
Symptoms vary depending on the tumor type, size, growth rate, and location within the spine.
Progressive back or neck pain is often the earliest symptom and may be persistent, worse at night, or unrelated to physical activity.
As tumors enlarge, they can compress the spinal cord or nearby nerve roots and lead to numbness, tingling, weakness, loss of coordination, gait instability, sensory changes, or radiating pain into the arms, trunk, or legs.
More advanced compression may affect bowel, bladder, or sexual function.
MRI of the spine with contrast is the preferred imaging test for evaluating spinal cord tumors because it provides highly detailed visualization of the spinal cord, nerve roots, meninges, vertebrae, and surrounding soft tissues.
Contrast-enhanced MRI helps distinguish tumor tissue from surrounding inflammation or edema and can often suggest the tumor type based on characteristic imaging features.
MRI is also essential for evaluating whether the tumor is compressing the spinal cord or causing swelling within the cord itself.
CT imaging is useful in select situations, particularly for evaluating bony destruction, calcifications, spinal instability, or when MRI cannot be performed.
PET/CT may be used when metastatic disease is suspected or when staging known cancer.
Brain MRI is sometimes recommended because certain tumors can occur at multiple locations throughout the central nervous system.
Biopsy or surgical sampling is often required to establish a definitive diagnosis when imaging findings are not fully conclusive.
Important to Know
Treatment of spinal cord tumors is highly individualized and typically coordinated through a multidisciplinary team that may include neurosurgery, neurology, radiation oncology, medical oncology, rehabilitation medicine, and neuroradiology specialists.
The goals of treatment often include relieving spinal cord compression, preserving neurological function, controlling tumor growth, maintaining spinal stability, and improving quality of life.
Some small, slow-growing benign tumors may be monitored with periodic imaging alone.
Other tumors may require surgery to remove or reduce the mass effect on the spinal cord.
Radiation therapy, including stereotactic radiosurgery techniques, is commonly used for many tumor types and for metastatic disease.
Chemotherapy, immunotherapy, or targeted therapy may be recommended depending on the tumor type and underlying cancer biology.
Early diagnosis is critically important because neurological deficits caused by prolonged spinal cord compression may become permanent if treatment is delayed.
Imaging findings are always interpreted together with symptoms, neurological examination findings, and any known history of cancer or genetic conditions.
Red flag symptoms include rapidly worsening weakness or numbness, gait or balance difficulty, loss of bowel or bladder control, severe or progressive back or neck pain, pain waking the patient at night, unexplained weight loss, or sudden neurological decline. These symptoms require urgent medical evaluation because they may indicate spinal cord compression or another serious neurological condition.