Vertebral tumors, also called extradural tumors, form between the vertebrae of the spine, and can be malignant or benign. Although a vertebral tumor can cause back pain, most back pain is caused by something other than a tumor. In general, a physician should be consulted when back pain persists and increases in intensity; cannot be linked to a particular activity; or gets worse at night. Anyone with a prior history of cancer who has sudden back pain should also be examined by a physician.
Types of Vertebral Tumors
Malignant Vertebral Tumors
Most malignant extradural spinal tumors originate in another part of the body before spreading to the spine; they are called secondary vertebral tumors. There are, however, some types that begin in the vertebrae; they are referred to as primary vertebral tumors. Primary vertebral tumors include:
Ewing's sarcoma is an aggressive tumor that usually affects 4- to 15-year-olds. It is the second-most-common bone cancer in children, but is relatively rare, accounting for only 1 percent of childhood cancers.
Multiple myeloma is a cancer of the bone marrow that usually affects older adults. It constitutes 1 percent of all cancers.
Osteosarcoma is the most common bone cancer in children. The average age at which it is diagnosed is 15, and boys are more likely to develop it than girls.
Benign Vertebral Tumors
Although a vertebral tumor may be benign, it can still cause severe problems, including chronic pain, spinal curvature and neurological damage.
Vertebral hemangiomas are usually found in the lower region of the spine. Mainly asymptomatic, they are often discovered only when another condition is being treated. They occur in approximately 10 percent of the population.
Osteoblastomas, which usually affect young adults, are fast-growing tumors whose main symptom is pain. They are quite rare, accounting for less than 1 percent of primary bone tumors.
Smaller than osteoblastomas, osteoid osteomas occur most commonly in those between the ages of 4 and 25. They can be quite painful, particularly at night. Men are three times more likely than woman to be affected.
Causes of Vertebral Tumors
The cause of most primary spinal tumors is unknown, although exposure to cancer-causing agents may play a part. And because spinal tumors in general tend to run in families, a genetic component is suspected.
Signs of Vertebral Tumors
Signs of vertebral tumors may include:
Back pain Difficulty walking, sometimes resulting in falls Decreased sensitivity to pain, heat and cold Loss of bowel or bladder function Loss of sensation or muscle weakness, particularly in the legs Paralysis (from nerve compression)
Diagnosis of Vertebral Tumors
Primary vertebral tumors may be misdiagnosed, primarily because their symptoms are similar to those of more common degenerative spinal diseases. To diagnose spinal tumors in general, a neurological examination may be performed. Depending upon its results, the following tests may be performed:
- Cerebrospinal fluid examination
- Cytology (cell study) of cerebrospinal fluid
- Spine X-ray
- Spine CT scan
- Spine MRI scan
Treatment for Vertebral Tumors
Depending upon its specific location and size, treatment for a malignant vertebral tumor will vary. Common treatment options for malignant vertebral tumors, and malignant spinal tumors in general, include:
- Radiation therapy
For a benign vertebral tumor that is small and asymptomatic, a doctor may choose only to observe it over time. For fast-growing benign vertebral tumors, surgery may be performed as long as removing the tumor will not cause nerve damage.