Spine Tumors

Spine Tumors

Spinal Gliomas

Glial cells support the central nervous system. Glial cells create gliomas. Spinal gliomas produce swelling throughout the spinal cord and cause loss of local function, pain and subsequent loss of spinal cord function beneath the damaged nerve.

Various genetic predispositions to developing spinal cord tumors have been identified including neurofibromatosis type 1 as well as monosomy of chromosome 22 and other familial clusters. It was previously thought that infection with simian virus 40 T antigen was associated with subsequent development of spinal ependymomas, but no studies have demonstrated such a link.

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Treatment options for spinal cord gliomas depend on the type of tumor and the symptoms present. Initial treatment in the case of spinal cord compression may often include corticosteroids. However, surgical resection is the mainstay in tumors of the spinal cord. As a result, the extent to which a tumor can be resected often has a great bearing on its prognosis. Also, depending on the tumor type, post-operative radiotherapy may be considered, which may also improve long-term survival.

Meningiomas

Our spinal cord is protected by a membrane called the meninges, consisting of three layers; the dura mater, the arachnoid matter, and the pia mater. Meningiomas are tumors that arise in this specific type of tissue. The meningiomas are often benign and not life threatening however there are rare cases of malignancy and obstruction of surrounding tissue. When patients present with symptoms they often have headaches, nausea, seizures, weakness or numbness in the limbs or face, visual problems and subsequent changes in mood or personality. As the tumor size increases, the symptoms increase in severity as well.

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Imaging study are key to diagnosing meningiomas. CT scans and MRI’s give information about the size, location and surrounding structures. There is a specialized imaging study called an angiogram that visualizes blood flow.

Patients who do not exhibit any symptoms of a meningioma will often be observed over time. The first line of treatment for patients exhibiting symptoms is surgery. Typically, complete resection offers a cure. However due to location and size, complete resection may not be an option. Dr. Yashar will advise all patients on the appropriate treatment and follow up of meningiomas.

Schwannomas

A Schwannoma is a benign nerve sheath tumor composed of Schwann cells which normally produce the insulating myelin sheath that covers peripheral nerves. Schwannomas are homogeneous tumors, consisting only of schwann cells. The tumor cells tend to proliferate on the outside of the nerve, although the tumor itself may either push the nerve aside, or even against a bony structure. While a vast majority of schwannomas are benign, less than 1% can become malignant, degenerating into a form of cancer known as a neurofibrosarcoma.

The cause of schwannomas remains unclear, although it appears that genetics does play a role. Most patients with spinal schwannomas are between the ages of 30 and 60 years old, though they can occur at any age. Those with a family history of spine cancer are at a higher risk.

As schwannomas grow, they can affect different part of the spine, nerves, blood vessels, and bones. This results in various symptoms that can include: Back pain, Weakness of numbness in the arms , Electric shock-like sensations when the affect area is touches, Loss of bowel or bladder, or even sexual function, Paralysis

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Because these symptoms can appear with or like other conditions, it is important that a patient is seen by a doctor for proper diagnosis and treatment. In left untreated, even non-cancerous tumors can grow and cause severe nerve and spine damage, including even paralysis.

After obtaining a thorough history of the patient and performing a physical exam, if a doctor believes a spinal tumor may be present, the following tests may be ordered: X-ray, CT Scan, (MRI).

Many schwannomas can be removed with minimally-invasive surgical techniques. This, however, is dependent upon the patient’s age and general health, as well as the size and location of the tumor. Additionally, not all tumors require resection—as these tumors are often benign and slow-growing, schwannomas that do not cause any symptoms can often be monitored, with serial imaging performed on a regular basis. In some cases, stereotactic radiosurgery (SRS) can be considered, as this represents a highly-focused form of radiation that be used to treat schwannomas.

Multiple Myeloma

Multiple myeloma, also known as plasma cell myeloma, is a cancer of plasma cells, a type of white blood cell that is normally responsible for producing antibodies. In multiple myeloma, collection of abnormal plasma cells accumulate in the bone marrow, where they interfere with the production of normal blood cells.

Many organ systems can be affected by myeloma, and, therefore, the symptoms can vary. Within the neurological system and the spine, symptoms can include:

  • Bone pain (from spread of tumors into the spine and ribs)
  • Pathologic Compression fractures (from weakening of the vertebral bodies)
  • Weakness, paralysis, or numbness/tingling (compression of the spinal cord and/or nerves)

A series of tests including labs, imaging and other diagnostic studies coupled with a physical exam with Dr. Yashar will diagnose multiple myeloma.

The treatment for multiple myeloma is focused on therapies that decrease the clonal plasma cell population and consequently decrease the signs and symptoms of disease. In regards to the spine, radiation therapy can be helpful for improving back pain from bony erosion of the spine, as well as limited further growth. In other cases, vertebroplasty or kyphoplasty can also provide relief of back pain from tumor growth. In the most severe cases, part of the bone of the spinal column may need to be removed, in order to relief compression of the spinal cord and/or nerve roots.

Spine Metastases

It is not uncommon for cancer cells to metastasize (spread to bones). They spread throughout the body and more commonly spread to the spine. These cancer cells form tumors and can make the bone so weak that it fractures. The tumors can also put pressure on nerve endings in and around the spine which causes pain and weakness in the arms and legs, and in extreme cases causes paralysis.

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