Spine and Spinal Cord Cancer

What is Spine and Spinal Cord Tumor?

After the spinal cord emerges from the skull, it runs through the bones of the spine up to the coccyx in the lower back. Benign or malignant tumors may occur in the spinal cord itself or in the membrane structure surrounding it. “What does it mean to have a tumor in the spinal cord?”, “What is a tumor in the spinal cord?”, “What do you mean a tumor in the spinal cord?” Such questions are asked by patients. Tumors in the spine and spinal cord can be benign as well as malignant tumors. The vast majority of tumors that appear in the spine surrounding the spinal cord occur as a result of metastasis. Breast cancer, lung cancer, prostate cancer are the most common cancers that metastasize to the spine.

What Are the Symptoms of Spine and Spinal Cord Tumor?

“What are the symptoms of spinal and spinal cord cancer?” , “How do spinal and spinal cord tumor effects occur?”, “What are the first signs of spine and spinal cord tumor?”, “How to understand the symptoms of spine and spinal cord tumor?” , “How to understand a dorsal tumor?”, “How to detect a lumbar tumor?” Such questions are asked by patients.

Symptoms of spinal cord tumors in children are generally as follows:

Since children cannot express their complaints more clearly than adults, complaints such as pain and weakness should be taken into consideration.

• If a toilet-trained child starts to wet the bed again, it is important to perform the necessary examinations as a sign of spinal cord tumor.
• The fact that a child who walks, runs and plays normally begins to fall and wobbles can also be a sign of a spinal and spinal cord tumor.

What are the Causes of Spine and Spinal Cord Tumor?

“Why does spine and spinal cord tumor occur?”, “Why does spinal and spinal cord tumor occur?”, “What are the causes of spinal and spinal cord tumors?”, “How does spinal and spinal cord tumor occur?” Questions like these are due to the curiosity of the subject. The causes of spinal cord tumors are not fully known, their physiopathology thinks that they may be caused by genetic causes. The vast majority of spinal tumors are metastatic tumors, and metastases are lung and breast cancer.

How to Diagnose Spine and Spinal Cord Tumor?

The diagnosis of spinal and spinal cord tumor is generally made by radiological imaging and biochemical blood tests.

For the diagnosis of spinal and spinal cord tumors, the doctor may request some radiological imaging after the examination,

• radiography, i.e. x-ray
• Bone scan scintigraphy
• Computed Tomography (CT)
• Magnetic Resonance (MR)
• In cases where the tumor is close to the surface, needle aspiration can be performed to determine from which tissues it originates or whether there is metastasis.
• In patients with spinal cord tumor symptoms, blood tests are performed to determine the presence of another tumor.

Performing radiological examinations with a special drug called a contrast agent can clearly reveal where the tumor is located, as well as its size and the nerves it compresses.

In the diagnosis of spinal cord tumor in children, sedation or general anesthesia should be used. This method is preferred because it is difficult for children to stay still in Magnetic Resonance (MR) or Computerized Tomography (CT).

How Is The Spine And Spinal Cord Tumor Treated?

In the treatment of spinal cord tumors, surgical methods, radiotherapy and chemotherapy treatments are generally applied. The treatment options to be used may differ depending on the patient, the type of tumor and its location. Pre-treatment planning is very important, treatment can be shaped according to the patient’s condition, the size of the tumor and the region where it is located. Some patients receive prior radiotherapy and chemotherapy, while others receive surgical treatment.

• The treatment of spinal cord tumors is carried out in a multidisciplinary approach consisting of different branches, including anesthesiologists experienced in medical oncology, radiation oncology, neurosurgery, interventional radiology, neurosurgery.
• When starting spinal cord tumor treatment, it is necessary to evaluate whether there is a problem with the integrity of the patient’s spine. Fractures may occur in the spine due to the tumor, and both the tumor tissue and the fracture may exert pressure on the spinal cord. Therefore, first of all, the patient’s spine structure should be ensured. Titanium screwing surgery can be performed to strengthen the spine.
• In spinal tumors arising through metastasis, it is necessary to evaluate whether the patient’s primary cancer is under control. If the life expectancy of the patient is long, more effective treatments may be considered for the tumor formed in the spine and spinal cord.
• In a small group of spinal tumors, which are generally seen as metastases, the entire tumor can be removed. In metastatic spine tumors that cannot be completely removed, techniques such as radiotherapy and chemotherapy can be used to enable the patient to maintain a social life more comfortably.

• In tumors originating from the spinal cord itself, the location is more important than how aggressive the tumor is. There is a big difference between surgery for a spinal cord tumor located in the neck and surgery for a spinal cord tumor located in the coccyx. There are serious risks such as respiratory paralysis in operations close to the neck area.
• Advanced technology radiotherapy devices can be used before or after surgery for the treatment of spine and spinal cord tumors. Generally, positive results can be obtained in slowing the development of benign tumors, stopping their growth and regressing them.

• Due to the sensitivity of the surgery of spinal cord tumors, advanced technology should be used in the surgery of spinal cord tumors, since it is a region where nerves that run the whole body are located. Neuromonitoring used in such risky surgeries can minimize possible complications.
• It may not always be possible to remove the entire tumor in spine and spinal cord tumors surgery. Removal of the entire tumor should be avoided if complete removal will harm the patient. For this, options such as radiotherapy and chemotherapy should be considered by removing the tumor at the maximum level.

What Are the Types of Spine and Spinal Cord Tumors?

Spine and spinal cord tumors can be classified according to the tissues of origin.

• Tumors originating from neurons, namely nerves, are tumors originating from the spinal cord itself.
• Tumors arising from the tissue vesicles surrounding the spinal cord.
  There may be tumors originating from the spine, that is, the bone structure.

Tumors originating from within the spinal cord itself are usually divided into two

• astrocytoma
• Ependymoma

Where Does the Spine and Spinal Cord Tumor Occur?

After the spinal cord exits the brain, it travels inside the spine to the coccyx. Spinal and spinal cord tumors can occur anywhere along this axis. Spine and spinal cord tumors; It can be seen in the neck spine or neck spinal cord, in the vertebrae surrounding the rib cage and on the spinal nerves in this region, as well as in the lumbar region up to the coccyx. Most of the tumors seen on the spine occur as a result of metastasis. Some of the spinal cord tumors can be seen more in certain regions. While some types of intraspinal tumors seen in adults are more common in the neck region, they can be seen in the spinal cord in the thoracic and lumbar regions in children.

How Is Spine and Spinal Cord Tumor Surgery Performed?

• Spine and spinal cord tumor operations are performed as open surgery with microsurgery method. Endoscopic method is not preferred in spine and spinal cord tumor surgery. Since two-dimensional images are obtained in endoscopic surgeries and a very small area is intervened, more successful results are obtained with open surgery in spine and spinal cord tumor surgeries.
• First of all, if the spine or spinal cord tumor is close in terms of accessibility, a biopsy is performed by taking a piece by needle aspiration method. This gives information about the type of tumor.
• By checking the spine strength, it is evaluated whether there is pressure on the spinal cord. If necessary, a technique called spinal screwing is used to ensure the stability of the spine.
• Pain is the biggest problem of patients with spinal tumor metastases. In some patients, it may not be possible to operate on the tumor. In such cases, surgical techniques can be applied to relieve the patient’s pain.
• In tumors originating from the spinal cord itself, the tumor is removed by open surgery using microsurgical techniques. By using the most advanced technology in spine and spinal cord tumor operation, the risks that may occur are minimized. The Neuromonitoring device used in these operations warns the neurosurgeon about the risky areas during the operation.
• Tissues removed in spine and spinal cord tumor surgery are sent to pathology and appropriate further treatment is planned.

What Are the Risks of Spine and Spinal Cord Tumor Surgery?

• Spinal and spinal cord tumors are tumors prone to bleeding. In some cases, interventional radiologists may perform vascular procedures before surgery to reduce bleeding during the surgical procedure. .
• As in all surgeries, there is a risk of infection in spine and spinal cord tumor surgeries.
• Especially in widespread tumors, risks of internal organ damage, damage to large vessels, and injury to the kidneys or urinary tract may occur.
• Paralysis is among the risks that can be experienced in spine and spinal cord tumor surgeries. However, this risk is minimized with the advanced technology used in the surgeries.
• As a result of the nerves being affected, problems such as urinary incontinence and inability to make bowel movements can be seen.