The spine, also called the backbone, is a flexible column of linked bones (vertebrae), muscles, tendons, and other tissues that extend from the base of the skull to the tailbone. It includes three protective membranes that encase the spinal cord and the fluid surrounding it. The spine provides structural support for the body and facilitates movements such as twisting and bending. The column of nerves in the spinal cord transmits signals to the brain to control movement, sensation, and bladder and bowel function.
Tumors can develop in the vertebrae, nerves, and other tissue throughout your spine. Some spine tumors, such as astrocytomas, occur more commonly in children and adolescents. (Learn more about pediatric brain and spinal cord tumors.)
Fewer than 10 percent of spine tumors begin in the spine. These tumors, called primary tumors, may be benign (noncancerous) or low-grade, malignant (cancerous) growths that are slow growing, or high-grade tumors that grow very aggressively. The vast majority of spine tumors are metastatic. These tumors arise from cancer that begins in another part of the body, such as the lungs, breasts, colon, prostate, kidneys, or thyroid gland. Sarcomas – cancers of the bone, muscle, or connective tissue – can also spread to the spine.
Types of Spine Tumors
There are many different types of spine tumors, which are identified by their location and the type of cells they contain.
Most primary and metastatic spine tumors are epidural tumors. These tumors grow in the bones of the spine. As they grow, they can compress the spinal dura – a thick sac that contains the spinal cord, nerve roots, and spinal fluid.
Intradural tumors, found inside the spinal dura, include:
- Intramedullary tumors – tumors that grow within the spinal cord, such as ependymomas and astrocytomas
- Extramedullary tumors – tumors that grow outside the spinal cord, such as meningiomas, schwannomas, and myxopapillary ependymomas
Nerve plexus tumors such as neurofibromas and ganglioneuromas occur next to the spine in the nerve plexus, a network of intersecting nerves that transmits signals from the brain to the arms or legs.
As a spine tumor grows, it can replace bones or compress nerves, resulting in compression fractures or reduced blood supply to the spinal cord. Often, the first symptom of a spine tumor is the pain caused by these changes. The time of day at which the pain occurs can provide important information about the tumor.
- Pain that occurs mainly when you are moving – mechanical pain – usually means that the tumor is causing weakness or instability in the bones of the spine.
- Pain experienced primarily at night or in the early morning that lessens with movement is often an early sign that the tumor has spread. This is because your adrenal gland, which makes steroids during the day to help prevent inflammation, becomes less active when you are sleeping.
Spine tumors that are close to major nerves can disrupt the nerves’ ability to receive and send messages between the body and the brain. This can cause neurologic symptoms such as:
- weakness, tingling, or numbness in both legs or arms
- difficulty walking or balancing
- sensory problems
- loss of bowel and bladder control