Cervical Spinal Tumours
The spinal cord extends from the base of the brain through the spinal canal and into the lower back. A spinal tumour is an abnormal growth of tissue that develops within the spinal cord, its surrounding structures, or the spinal column. Spinal tumours may be malignant (cancerous), with the potential to spread to other parts of the body, or benign (non-cancerous), remaining localised. Spinal tumours are classified according to their location in relation to the spinal cord and its protective coverings.
The two main types of spinal 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 tumours are not always known. Some may be inherited or associated with genetic abnormalities, while others may develop due to environmental factors or occur without an identifiable cause. Tumours originating in other parts of the body may 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 tumours vary depending on the type, size, and location of the tumour and may include:
- Back or neck 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 in different parts of the body
- Loss of bowel or bladder control
- Difficulty with balance, walking, or co-ordination
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 is sometimes appropriate for elderly patients or those for whom surgery may pose significant risks.
- Surgery: Surgical removal of the tumour is often the preferred treatment option. Modern microsurgical techniques, including the use of high-powered operating microscopes and advanced intraoperative monitoring, help maximise tumour removal while minimising the risk of damage to surrounding nerves and blood vessels. In some cases, ultrasonic surgical instruments may be used to break down the tumour 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
Recovery varies depending on the type of surgery performed, the location of the tumour, and the patient’s overall health. Following cervical spine surgery, the neck may feel stiff or sore, and sitting for extended periods may be uncomfortable. 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.
As a general guide, patients may expect:
- A hospital stay of approximately three to five 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
- Restrictions on driving for approximately four to six weeks, depending on recovery progress
- Avoidance of swimming for four to six weeks
- Physiotherapy and rehabilitation, as required
- Ongoing pain management, if necessary
Dr Tollesson will provide individual recovery recommendations based on the procedure performed and your specific circumstances.
