Spinal tumors are relatively uncommon compared to other types of tumors. According to statistics from the American Cancer Society, about 10,000 people in the United States are diagnosed with primary tumors of the spine each year. This represents less than 5% of all primary tumors that occur in the body.
Incidence and Prevalence
The incidence of spinal tumors refers to the number of new cases diagnosed each year. As mentioned above, this is estimated at around 10,000 cases per year in the United States. The prevalence refers to the total number of people living with a spinal tumor at any given time. This is harder to estimate, but based on incidence rates, there may be around 50,000-60,000 people living with a diagnosed spinal tumor in the US.
Some key points on spinal tumor incidence and prevalence:
- Primary spinal tumors are much less common than spinal metastases (tumors that have spread from another part of the body). Metastatic spinal tumors are estimated to occur in up to 70% of cancer patients.
- Intradural extramedullary tumors are the most common type of primary spinal tumor in adults, accounting for about 55% of cases.
- Intramedullary tumors predominately occur in children and make up about 35% of primary spinal tumors in pediatrics.
- The most common types of malignant primary spinal tumors are myelomas, lymphomas, nerve sheath tumors, and astrocytomas.
- Benign tumors such as meningiomas, schwannomas, and neurofibromas are more common than malignant spinal tumors.
Risk Factors
There are a few known risk factors that can increase someone’s chance of developing a spinal tumor:
- Age – Different spinal tumors tend to occur at different ages. Schwannomas and meningiomas often arise in middle age. Ependymomas and astrocytomas more often occur in children or younger adults.
- Genetics – Genetic conditions like neurofibromatosis and Li-Fraumeni syndrome are associated with an increased spinal tumor risk.
- Prior radiation treatment – People who have had radiation to the spine have a higher chance of developing certain spinal tumors later on.
- Cancer history – Those with a history of other cancers have an increased risk of metastatic spinal tumors.
However, in many cases, spinal tumors occur sporadically with no known cause or risk factors.
Symptoms
Symptoms of spinal tumors depend on the location and type of growth. Some general symptoms can include:
- Back or neck pain
- Radiculopathy – nerve pain radiating down the arms or legs
- Muscle weakness or numbness in the extremities
- Difficulty walking
- Abnormal sensations or loss of bladder/bowel control (in advanced cases)
Symptoms often develop slowly but can worsen over time as the tumor grows. Pain at night that disrupts sleep is a common early symptom. Anyone experiencing concerning neurologic symptoms should see a doctor for prompt evaluation.
Diagnosis
If a spinal tumor is suspected based on clinical exam, doctors will perform imaging tests to confirm the diagnosis and identify the exact location. Common diagnostic tests include:
- MRI – The preferred imaging test for spinal tumors. Provides excellent visualization of the spinal cord and surrounding soft tissues.
- CT – May be used to look at calcifications or bone changes associated with tumors.
- X-ray – Helps detect any spinal misalignment or instability.
- Biopsy – A tissue sample of the tumor may be taken to determine if cancerous and identify specific tumor type.
Neurologic tests such as an EMG may also be done to assess nerve damage related to the spinal tumor.
Treatment
Treatment depends on the type of tumor, its location, and whether it is benign or malignant. Common treatment approaches include:
- Surgery – Complete or partial surgical removal of the tumor. Often performed for accessible benign tumors or malignant tumors limited to one area.
- Radiation – High energy beams used to shrink and kill tumor cells. May be used alone or after surgery.
- Chemotherapy – Drug treatment to destroy cancer cells. Often used for malignant tumors that are inoperable or have spread.
- Steroids – Used to reduce swelling and pressure on the spinal cord caused by tumors.
Treatment aims to stop tumor growth and nerve damage while preserving neurologic function. Rehabilitation is often needed after treatment to help regain strength, coordination, and mobility.
Prognosis
The outlook for spinal tumors varies greatly and depends on:
- If the tumor is benign or malignant
- The size and location of the tumor
- How early it is detected
- If it has spread beyond the spine
- The patient’s overall health
Benign spinal tumors generally have very good outcomes with appropriate treatment. However, malignant spinal tumors can be challenging to treat and have poorer long-term survival rates.
When diagnosed early, many malignant spinal tumors can be treated effectively with surgery and radiation. If the cancer has already spread at diagnosis, treatment is more difficult and survival rates are lower.
Conclusion
In summary, primary spinal tumors are relatively uncommon compared to other tumor types. Incidence is estimated around 10,000 cases per year in the United States. While any part of the spine can be affected, certain tumors tend to occur in specific age groups and locations.
Symptoms depend on the tumor location but often include back pain, nerve pain, and neurologic deficits. MRI is the preferred diagnostic imaging test. Treatment options include surgery, radiation, chemotherapy, and steroids. Prognosis varies significantly based on tumor type, location, size, and metastasis.
Increased awareness of spinal tumor symptoms among medical providers and patients is important for early diagnosis and timely treatment. Continued research into spinal tumor biology and advanced treatment options is needed to improve long-term outcomes, especially for high-risk or metastatic spinal tumors.
