Spine diseases that cause back pain include herniated discs, spinal stenosis, and back sprains. However, if the patient is accompanied not only by simple pain but also by neurological symptoms such as decreased sensation, paralysis and difficulty walking, a “vertebral tumor” should be suspected. What type of disease is spinal tumor?
If the symptoms of back pain and paresthesia appear together, you should suspect a spinal tumor |
Spinal tumor, very likely to be a metastatic cancer… It is even more dangerous because it is confirmed late.
Spinal tumor refers to all tumors that occur in the spine, such as giant cell tumor, osteoblastoma, hemangioma, and chondrosarcoma. It is broadly divided into primary spinal tumors, which initially develop in the spine itself, and metastatic spinal tumors, which are malignant tumors that originate elsewhere in the body and migrate to the spine. Primary tumors are further divided into benign tumors and malignant tumors, while metastatic tumors are mostly cancer-related malignancies.
In particular, it is known that approximately 70-90% of tumors occurring in the spine are metastatic spinal tumors such as chondrosarcoma, Ewing’s sarcoma, and chordoma. Breast cancer, prostate cancer, thyroid cancer, lung cancer, and kidney cancer can easily metastasize to the bones and, most commonly, the spine. By the time a metastatic spinal tumor is discovered, cancer elsewhere in the body has often already progressed to stage 3 or 4 or higher.
Depending on the cancer, there are cases where it spreads to the spine without symptoms until the disease is diagnosed, and in some cases, the cancer metastasizes late even after the original cancer has been treated, so caution is needed. Professor Youngjun Kim, Consultant Neurosurgery Hidoc (Samsung Changwon Hospital, Sungkyunkwan University) said: “In the case of breast cancer, the time required for breast cancer to metastasize to other organs is long, on average, more than 4 years, so even if the original cancer has improved enough to be considered cured, it may be too late “When a tumor is discovered in the spine, the presence of metastases is sometimes confirmed,” he said.
Symptoms similar to lumbar disc herniation and spinal cord tumor… How to distinguish them?
A typical symptom that may indicate a spinal tumor is pain at the site of the tumor. If it occurs in the neck (cervical spine), it causes neck pain, while if it occurs in the lower back (lumbar spine), it causes back pain. In the early stages of spinal tumor development there are no major problems other than pain, so it is often difficult to distinguish it from general spinal diseases. Subsequently, symptoms such as numbness and sensory abnormalities gradually appear due to compression of the spinal nerves. As the tumor grows, the bone weakens, making spinal fractures more likely to occur. However, because tumors are often not detected by X-rays before bone damage such as fractures occurs, MRI, CT, and biopsy must be performed for an accurate diagnosis.
Caution should be exercised in the early stages of spinal tumor development as it can easily be confused with other spinal diseases such as lumbar disc disease. Lumbar discs and spinal tumors can be distinguished based on the type of radiating pain. Radiating pain caused by a herniated disc tends to extend to the lower body, such as the buttocks and legs. On the other hand, spinal tumors are different in that pain and sensory abnormalities can occur not only in the lower body but also in the upper body, such as the arms and shoulders. Additionally, if you experience symptoms such as paralysis of the lower body, difficulty walking, or difficulty defecating or urinating, a spinal tumor, not a lumbar disc, should be suspected.
It is also necessary to distinguish it from spinal tumors that cause back pain and neurological symptoms. The spinal cord is part of the central nervous system within the spine, and because it is an organ that cannot be separated from the spine, the terms spinal tumor and spinal cord tumor are often used interchangeably. Spinal cord tumor refers to a tumor that occurs in the spinal nerves within the vertebrae. Spinal cord tumors are mostly primary tumors that grow from the spinal nerve itself, and compared to spinal tumors that cause fractures, symptoms of nerve damage such as paralysis and decreased sensation tend to be more severe. If a spinal tumor is discovered early and surgery is performed to remove it while minimizing nerve damage, the prognosis is better than that of a spinal tumor.
Treatment varies depending on the type and stage of progression… Be careful if you have a history of cancer
There is no way to prevent the development of spinal tumors, but if symptoms such as characteristic paresthesias, back pain or paralysis appear, it is important to identify the exact cause and treat it at an early stage. In particular, because metastatic tumors are common, patients who have suffered from cancer in any area should be especially careful and go to the hospital immediately if they have any abnormal symptoms.
When treating spinal tumors, primary and metastatic tumors are distinguished, and surgery is decided based on the stage of progression. This is because the structure of the spine itself is complex, and because the nerves are close together, complications due to nerve damage are likely to occur. Nerve damage and lower body paralysis have a significant impact on the patient’s quality of life after surgery and must be considered when choosing treatment.
According to the Korean Society of Spine Neurosurgery, among primary benign tumors, hemangioma, osteoid osteoma, and osteoblastoma can be seen without separate surgery unless the vertebrae are severely destroyed or the tumor does not compress the nerves. In particular, early diagnosis is very important for primary tumors because the degree of damage to the bones and nerves is relatively low and, even if malignant, helps to increase the survival rate.
In the case of metastatic tumors, the type and condition of the causative cancer, the patient’s systemic condition, and life expectancy must be comprehensively considered. This is because the 5-year survival rate after treatment is relatively low, less than 10%, and complete recovery is difficult even with active treatment. In the case of metastatic tumors, the main goal of treatment is to reduce pain as much as possible and improve quality of life while preserving nerve function. Basically, anti-tumor treatment is performed using radiation therapy or targeted anti-tumor drugs, and in cases of spinal fractures or severe nerve compression, screw fixation and decompression surgery can be used to treat the condition.
Meanwhile, even for metastatic tumors, it is known that if the patient can walk alone and has a long life expectancy, the treatment effect can be greater and the prognosis is relatively better. Therefore, rather than giving up treatment, it is recommended to implement appropriate treatment depending on the situation.
Help = Professor Kim Young-jun, Hidoc Consultant Physician (Neurosurgery Specialist, Samsung Changwon Hospital, Sungkyunkwan University)
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