Spinal Oncology

Cancer of the spine is a rare disease affecting about 24,000 Americans every year. Much like any form of cancer, spinal cancer forms when abnormal cells grow out of normal parameters in the spinal cord or the bones, tissues, fluid or nerves that surround it, eventually forming a tumor.

Signs of Spinal Tumors

Some common signs of spinal tumors may include:

  • Pain (back and/or neck pain, arm and/or leg pain)
  • Muscle weakness or numbness in the arms or legs
  • Difficulty walking
  • General loss of sensation
  • Difficulty with urination
  • Change in bowel habits
  • Paralysis to varying degrees
  • Spinal deformities
  • Pain or difficulty with standing

Once tumors have presented obvious symptoms relating to the spine, it is because cancer has moved from another location in the body, such as a kidney or breast, to the spine. This is tumor is now metastasized. While the word “metastasized” sounds intimidating, there are many options today for patients facing this diagnosis.

Symptoms vary from patient to patient, and doctors classify spinal cancer according to the location in the body.

Spinal cancer is graded in the following ways:

Grade I (grade 1 spinal cancer): The tumor grows slowly and rarely spreads into nearby tissues. It may be possible to completely remove the tumor with surgery.

Grade II (grade 2 spinal cancer): The tumor grows slowly but may spread into nearby tissue or recur.

Grade III (grade 3 spinal cancer): The tumor grows quickly, is likely to spread into nearby tissue, and the tumor cells look very different from normal cells.

Grade IV (grade 4 spinal cancer): The tumor grows and spreads very quickly, and the spinal tumor cells do not look like normal cells. Metastatic brain disease is almost always grade IV.

Types of Spinal Cancer

  • Hemangioblastoma - A hemangioblastoma is a benign (non-cancerous) vascular tumor located along the spine.
  • Hemangioma - Spinal hemangiomas are benign tumors often found in the mid-back (thoracic) and lower back (lumbar).
  • Meningioma - A meningioma is a tumor that grows in the protective lining of the brain and spinal cord.
  • Metastatic tumors - A metastatic tumor is a cancerous (malignant) growth that spreads from another part of the body.
  • Neurofibroma - Neurofibromas are benign (non-cancerous) tumors of the peripheral nerves.
  • Schwannoma - A schwannoma is a spinal tumor that arises from the lining of the nerve cells of the spine.
  • Vascular malformation - A vascular malformation is an abnormal collection or tangle of blood vessels on, in, or near the spinal cord.

Is Surgery An Option?

Neurosurgeons employ minimally invasive surgical techniques and 3-D technology to take diagnostic images of the spine or brain for safety and accuracy.

When performing minimally invasive spinal surgery, a neurosurgeon may be able to use small incisions and tubes to remove the tumor with fewer impacts on muscle tissue. This technique may help reduce pain and speed up recovery, while allowing the neurosurgeon to decompress the nerves of the spinal cord and access hard-to-reach tumors in and around the spinal cord.

Minimally Invasive Surgery

Intraoperative neuronavigation uses an advanced MRI system to map areas of the brain responsible for important functions. The map then allows us to precisely plan surgery to help avoid damage to those important areas.

Intraoperative electrophysiology “brain mapping” (also called motor mapping and language mapping) is like GPS for the brain.

Non-surgical Intervention

Chemotherapy

Doctors may deliver chemotherapy locally to the brain during surgery. Because chemotherapy is administered as close as possible to the brain tumor edges at the resection area rather than systemically, this technique may help to reduce typical chemotherapy-related side effects.

Radiation Therapy

Doctors may also use intraoperative radiation therapy (IORT) to deliver radiation directly to the area where a tumor has been removed. This may help avoid damage to surrounding normal structures, particularly the scalp and the skin on the scalp.