Thoracic & Lumbar Spinal Tumours
The spinal cord extends from the base of the brain, through the spinal canal, to the lower back. A spinal cord tumour is an abnormal growth of tissue that develops within the spinal cord or surrounding structures. These tumours may be malignant (cancerous), with the potential to spread to other parts of the body, or benign (non-cancerous), remaining localised. Spinal cord tumours are classified according to their location in relation to the spinal cord and its protective coverings.
The two main types of spinal cord tumours include:
- Intramedullary tumours – tumours that arise within the spinal cord itself.
- Extramedullary tumours – tumours that develop in the tissues surrounding and supporting the spinal cord.
The exact causes of spinal cord tumours are not always known. Some may be inherited, associated with genetic abnormalities, or linked to environmental factors. Tumours originating in other parts of the body can also spread (metastasise) to the spine. Regardless of their type, spinal tumours can cause significant complications because of their proximity to the spinal cord and nerve roots.
Symptoms
Symptoms of spinal cord tumours vary depending on the type, size, and location of the tumour and may include:
- Back pain that radiates to other parts of the body
- Reduced sensitivity to pain, heat, or cold
- Numbness or loss of sensation in the arms or legs
- Muscle weakness or twitching in different parts of the body
- Loss of bowel or bladder control
Diagnosis and Treatment Options
Spinal tumours can be difficult to diagnose because their symptoms often resemble those of other spinal conditions. When patients present with symptoms suggestive of a spinal tumour, a thorough medical history, physical examination, and neurological assessment are performed.
Diagnostic investigations may include magnetic resonance imaging (MRI), computed tomography (CT) scans, and, in some cases, a biopsy. A biopsy involves removing a small sample of tissue for examination under a microscope to determine the type of tumour and guide treatment planning.
Treatment is aimed at controlling or removing the tumour while preserving neurological function. The most appropriate treatment will depend on the patient’s age, overall health, tumour type, size, and location.
Treatment options may include:
- Monitoring: If a tumour is small, slow-growing, and not causing symptoms, regular monitoring with clinical assessments and imaging studies may be recommended. This approach may be appropriate for older patients or those for whom surgery presents significant health risks.
- Surgery:Surgical removal of the tumour is often the preferred treatment option. Tumour excision is performed using high-powered operating microscopes while monitoring the function of the surrounding nerves and blood vessels to minimise the risk of injury. In some cases, ultrasonic surgical instruments may be used to break down the tumour into smaller fragments before removal. If complete removal is not possible, surgery may be combined with radiation therapy and/or chemotherapy.
- Radiation therapy: Radiation therapy uses high-energy radiation to destroy tumour cells. It may be used after surgery to treat any remaining tumour tissue, as a primary treatment when surgery is not appropriate, or for metastatic tumours that have spread to the spine. Stereotactic radiosurgery (SRS) is a highly precise form of radiation therapy that delivers a focused dose of radiation directly to the tumour. Potential side effects may include fatigue, nausea, and vomiting.
- Chemotherapy: Chemotherapy involves the use of medications to destroy tumour cells or slow their growth. It may be used alone or in combination with surgery and radiation therapy. Common side effects may include fatigue, nausea, and hair loss.
Recovery
Following surgery, your back may feel stiff or sore for a period of time, and you may find it uncomfortable to sit or remain in one position for extended periods. Activities such as lifting, bending, and twisting may be restricted during the early stages of recovery. Pain medication is commonly prescribed to assist with post-operative discomfort.
Recovery varies depending on the individual patient, the location of the tumour, and the type of surgery performed. As a general guide, recovery may include:
- A hospital stay of approximately five to seven days
- Avoidance of heavy lifting during the initial recovery period, with gradual progression of activity as advised
- Time away from work to allow for healing and recovery
- A temporary return to work on modified or restricted duties, if required
- Restrictions on driving for approximately four to six weeks, depending on recovery progress and medical advice
- Avoidance of swimming for four to six weeks
- Physiotherapy and rehabilitation, as required
- Ongoing pain management, if necessary
- Use of a back brace in some cases
- Assessment and support from an Occupational Therapist, if required
Dr Tollesson will provide specific recovery recommendations based on your individual condition, surgical procedure, and recovery progress.
