In rare cases, nerve, bone marrow or, bony tumors can arise in the spine itself. At age 22, other musculoskeletal problems are far more common as cause of low back pain.
An MRI is usually the best way to image the spinal cord and nerves in the spine. Determining whether the tumor is malignant or benign, identifying its source, and finding the total number of lesions will play a part in prognosis.
The primary care physician will often refer a patient for imaging studies to help identify the source of the pain. MRIs, which can show the softer tissues, can detect disease tumor earlier than X-rays and CT scans.
Sometimes a contrast agent is injected into a vein in the hand or arm during the test, which highlights certain tissues and structures to make tumor identification clearer. Computerized tomography (CT): This test uses a narrow beam of radiation to produce detailed images of your spine.
Like the MRI, sometimes a contrast agent is injected into a vein in the hand or arm during the test, which highlights certain tissues and structures to make tumor identification clearer. Pyelogram: This test uses a dye that is injected directly into the spinal column, and is used in conjunction with an X-ray, MRI, or CT scan.
If the cells are cancerous, the tumor will be graded 1-4 for its aggressiveness, and the medical team will develop and recommend a treatment plan. Side effects are usually moderate and limited and the procedure carries a very low risk of infection or other complications that can occur after open surgery.
The doctor will also check your brain and spinal cord function by testing things like your reflexes, muscle strength, vision, eye and mouth movement, coordination, balance, and alertness. If the results of the exam are abnormal, you may be referred to a neurologist (a doctor who specializes in medical treatment of nervous system diseases) or a neurosurgeon (a doctor who specializes in surgical treatment of nervous system diseases), who will do a more detailed neurologic exam and may order other tests.
These tests use x-rays, strong magnets, or radioactive substances to create pictures of the brain and spinal cord. Magnetic resonance imaging (MRI) and computed tomography (CT) scans are used most often to look for brain diseases.
A contrast material called gadolinium may be injected into a vein before the scan to help see details better. It measures biochemical changes in an area of the brain (displayed in graph-like results called spectra, although basic images can also be created).
MRS can also be used after treatment to help determine if an area that still looks abnormal on another test is remaining tumor or if it is more likely to be scar tissue. A special type of MR image is then obtained to look at the amount of blood going through different parts of the brain and tumor.
It can also be used after treatment to help determine if an area that still looks abnormal is remaining tumor or if it is more likely to be scar tissue. Functional MRI (fMRI): This test looks for tiny blood flow changes in an active part of the brain.
It can be used to determine what part of the brain handles a function such as speech, thought, sensation, or movement. Doctors can use this to help determine which parts of the brain to avoid when planning surgery or radiation therapy.
This test is similar to a standard MRI, except that you will be asked to do specific tasks (such as answering simple questions or moving your fingers) while the scans are being done. A CT scan uses x-rays to make detailed cross-sectional images of your brain and spinal cord (or other parts of the body).
Unlike a regular x-ray, a CT scan creates detailed images of the soft tissues in the body. The scan creates detailed images of the blood vessels in the brain, which can help doctors plan surgery.
For a PET scan, you are injected with a slightly radioactive substance (usually a type of sugar known as FDP) which collects mainly in tumor cells. The picture is not as detailed as a CT or MRI scan, but it can provide helpful information about whether abnormal areas seen on other tests (such as MRIs) are likely to be tumors or not.
This test is also useful after treatment to help determine if an area that still looks abnormal on an MRI scan is remaining tumor or if it is more likely to be scar tissue. Imaging tests such as MRI and CT scans may show an abnormal area that is likely to be a brain or spinal cord tumor.
In rare cases a PET scan or MR spectroscopy may give enough information so that a biopsy is not needed. If the patient is awake, the neurosurgeon injects a local anesthetic into areas of skin above the skull to numb them.
An image-guidance system is then used to direct a hollow needle into the tumor to remove small pieces of tissue. An MRI or CT scan is often used along with the frame to help the neurosurgeon guide a hollow needle into the tumor.
The removed tissue is sent to a pathologist (a doctor specializing in diagnosis of diseases by lab tests). If imaging tests show the tumor can likely be treated with surgery, the neurosurgeon may not do a needle biopsy.
For a preliminary diagnosis, small samples of the tumor are looked at right away by the pathologist while the patient is still in the operating room. Finding out which type of tumor someone has is very important in helping to determine their outlook (prognosis) and treatment options.
But in recent years, doctors have found that changes in certain genes, chromosomes, or proteins within the cancer cells can also be important. In high-grade gliomas, the presence of MGMT promoter methylation is linked with better outcomes and a higher likelihood of responding to chemotherapy.
This test is used mainly to look for cancer cells in the cerebrospinal fluid (CSF), the liquid that surrounds the brain and spinal cord. Lumbar punctures are usually very safe, but doctors have to make sure the test does not result in a large drop in fluid pressure inside the skull, which could possibly cause serious problems.
These lab tests rarely are part of the actual diagnosis of brain and spinal cord tumors, but they may be done to check how well the liver, kidneys, and some other organs are working. An X-ray is a test that uses radiation to produce images of the bones and organs of the body.
During an X-ray, a focused beam of radiation is passed through your body, and a black-and-white image is recorded on special film or a computer. X-rays work because the body's tissues vary in density (thickness).
Each tissue allows a different amount of radiation to pass through and expose the X-ray -sensitive film. Bones, for example, are very dense, and most of the radiation is prevented from passing through to the film.
A radiology technologist, a skilled medical professional who is trained in X-ray procedures, will perform the test. Spinal tumor is not the first thing you think of,” says James Schuster, MD, PhD, Associate Professor of Neurosurgery at Penn Medicine.
“Spinal cord tumors usually grow slowly,” adds Neil Malta, MD, Assistant Professor of Neurosurgery at Penn Medicine. While there are a number of potential causes of spinal tumors, by far most people who develop them have a history of other cancers.
Dr. Malta explains that this is extra important for patients who are undergoing cancer treatment or who are in remission. If they begin experiencing strange symptoms, they should be more rigorously screened for spinal tumors than patients without a cancer history.
“While back pain is common, spinal tumors, fortunately, are uncommon,” says Dr. Schuster. Dr. Schuster adds that at Penn Medicine, spinal tumors might seem more common than they are in the general population because doctors from throughout the region refer complicated cases to the specialists there.
Most often, a person will visit her primary care physician complaining of back pain and possibly a handful of other symptoms. The physician might prescribe conservative treatments as well, such as non-steroidal anti-inflammatory drugs (NSAIDs) or physical therapy.
MRI scan of spinal cord tumor Open pop-up dialog close For that reason, it's especially important that your doctor know your complete medical history and perform both general physical and neurological exams.
MRI uses a powerful magnetic field and radio waves to produce accurate images of your spine, spinal cord and nerves. MRI is usually the preferred test to diagnose tumors of the spinal cord and surrounding tissues.
A contrast agent that helps highlight certain tissues and structures may be injected into a vein in your hand or forearm during the test. Some people may feel claustrophobic inside the MRI scanner or find the loud thumping sound it makes disturbing.
But you're usually given earplugs to help with the noise, and some scanners are equipped with televisions or headphones. This test uses a narrow beam of radiation to produce detailed images of your spine.
Sometimes it's combined with an injected contrast dye to make abnormal changes in the spinal canal or spinal cord easier to see. A CT scan is only rarely used to help diagnose spinal tumors.
The only way to determine the exact type of spinal tumor is to examine a small tissue sample (biopsy) under a microscope. The biopsy results will help determine treatment options.
Ideally, the goal of spinal tumor treatment is to eliminate the tumor completely, but this goal may be complicated by the risk of permanent damage to the spinal cord and surrounding nerves. The type of tumor and whether it arises from the structures of the spine or spinal canal or has spread to your spine from elsewhere in your body also must be considered in determining a treatment plan.
Spinal tumor neck surgery Open pop-up dialog close Using microsurgical techniques, a tumor is gently teased out of the spinal cord in the cervical spine.
During observation, your doctor will likely recommend periodic CT or MRI scans at an appropriate interval to monitor the tumor. This is often the treatment of choice for tumors that can be removed with an acceptable risk of spinal cord or nerve injury damage.
Newer techniques and instruments allow neurosurgeons to reach tumors that were once considered inaccessible. The high-powered microscopes used in microsurgery make it easier to distinguish tumor from healthy tissue.
Doctors also can monitor the function of the spinal cord and other important nerves during surgery, thus minimizing the chance of injuring them. In some instances, very high-frequency sound waves might be used during surgery to break up tumors and remove the fragments.
But even with the latest technological advances in surgery, not all tumors can be totally removed. When the tumor can 't be removed completely, surgery may be followed by radiation therapy or chemotherapy or both.
Recovery from spinal surgery may take weeks or longer, depending on the procedure. You may experience a temporary loss of sensation or other complications, including bleeding and damage to nerve tissue.
Medications may help ease some side effects of radiation, such as nausea and vomiting. Sometimes, your radiation therapy regimen may be adjusted to help minimize the amount of healthy tissue that's damaged and to make the treatment more effective.
Your doctor can determine whether chemotherapy might be beneficial for you, either alone or in combination with radiation therapy. Side effects may include fatigue, nausea, vomiting, increased risk of infection and hair loss.
Because surgery and radiation therapy as well as tumors themselves can cause inflammation inside the spinal cord, doctors sometimes prescribe corticosteroids to reduce the swelling, either after surgery or during radiation treatments. Although corticosteroids reduce inflammation, they are usually used only for short periods to avoid serious side effects such as muscle weakness, osteoporosis, high blood pressure, diabetes and an increased susceptibility to infection.
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease. During acupuncture treatment, a practitioner inserts tiny needles into your skin at precise points.
Research shows that acupuncture may be helpful in relieving nausea and vomiting. Acupuncture might also help relieve certain types of pain in people with cancer.
Be sure to discuss the risks and benefits of complementary or alternative treatment that you're thinking of trying with your doctor. Some treatments, such as herbal remedies, could interfere with medicines you're taking.
The more you and your family know and understand about your care, the more confident you'll feel when it comes time to make treatment decisions. You may have a close friend or family member who is a good listener.
Other people with spinal tumors may be able to offer unique insights. Online discussion boards, such as those offered by the Spinal Cord Tumor Association, are another option.
Choose a healthy diet rich in fruits, vegetables and whole grains whenever possible. Reduce stress in your life by taking time for relaxing activities, such as listening to music or writing in a journal.
Here's some information to help you get ready for your appointment, and what to expect from the doctor. Note any family history of brain or spinal tumors, especially in a first-degree relative, such as a parent or sibling.
Do you have any family history of noncancerous or cancerous spinal tumors? Brain and spinal tumors: Hope through research.
Welch WC, et al. Spinal cord tumors. Treatment and prognosis of neoplastic epidural spinal cord compression, including caudal equine syndrome.