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Spinal Cord Tumor – Causes, Symptoms & Treatment

A spinal cord tumor is an abnormal growth in or around the spinal cord that can cause serious neurological symptoms. Early diagnosis and treatment are essential.

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A spinal cord tumor is an abnormal growth in or around the spinal cord that can cause serious neurological symptoms. Early diagnosis and treatment are essential.

What is a Spinal Cord Tumor?

A spinal cord tumor is an abnormal mass of tissue that develops within the spinal cord itself, in the membranes (meninges) surrounding it, or in the adjacent vertebral structures. These tumors can be benign (non-cancerous) or malignant (cancerous) and may cause significant neurological damage by compressing nerve fibers. Although relatively rare, spinal cord tumors can occur at any age.

Types of Spinal Cord Tumors

Spinal cord tumors are classified according to their location within the spinal canal:

Intramedullary tumors: These grow within the spinal cord tissue itself. Common types include ependymomas and astrocytomas.
Intradural-extramedullary tumors: Located inside the dura mater (the outer membrane of the spinal cord) but outside the cord itself. Meningiomas and neurofibromas belong to this category.
Extradural tumors: These are found outside the dura mater, often in the vertebral body or the epidural space. They are frequently caused by metastases from other cancers.

Causes and Risk Factors

The exact causes of primary spinal cord tumors are largely unknown. The following factors are associated with an increased risk:

Genetic conditions: Neurofibromatosis type 1 and type 2, Von Hippel-Lindau syndrome
Radiation exposure: Previous radiation therapy to the spinal region
Secondary tumors (metastases): The most common cause of extradural tumors, originating from lung, breast, prostate, or kidney cancer
Immune suppression: Increased risk of certain spinal lymphomas in individuals with HIV or following organ transplantation

Symptoms

Symptoms depend greatly on the size and location of the tumor. Common signs include:

Back or neck pain that worsens at night or when lying down
Muscle weakness or paralysis in the arms or legs
Sensory disturbances such as numbness, tingling, or a burning sensation
Gait problems and loss of coordination
Bladder and bowel dysfunction (incontinence or urinary retention)
Sexual dysfunction

Symptoms often develop gradually over weeks to months, but can also deteriorate suddenly.

Diagnosis

Diagnosing a spinal cord tumor involves several steps:

Neurological examination: Assessment of reflexes, muscle strength, and sensation
Magnetic Resonance Imaging (MRI): The preferred imaging method for visualizing the spinal cord and precisely locating the tumor, typically performed with contrast enhancement
Computed Tomography (CT): Used as a complement to MRI, particularly to assess bony structures
Biopsy: Tissue sampling for histological confirmation of the diagnosis
Lumbar puncture (spinal tap): Analysis of cerebrospinal fluid for tumor cells
Laboratory tests and staging investigations: Performed when metastatic disease is suspected

Treatment

Treatment depends on the type, location, and extent of the tumor, as well as the overall health of the patient:

Surgery

Neurosurgical removal of the tumor is often the first-line treatment. In cases of benign, well-defined tumors, complete removal may be possible. The goal is always maximal tumor resection while preserving neurological function.

Radiation Therapy

Radiation therapy is used when the tumor cannot be completely removed surgically, for malignant tumors, or in cases of recurrence. Stereotactic radiosurgery (e.g., Gamma Knife) allows highly precise radiation delivery while minimizing damage to surrounding healthy tissue.

Chemotherapy

Chemotherapy is indicated for certain malignant spinal tumors (e.g., spinal lymphomas, high-grade ependymomas) or for metastatic disease.

Corticosteroids

Corticosteroids such as dexamethasone may be administered acutely to reduce tumor-related swelling and relieve symptoms.

Rehabilitation

Following treatment, neurological rehabilitation is often necessary to restore lost functions as much as possible and to improve quality of life.

Prognosis

The prognosis depends primarily on the tumor type, the extent of neurological damage before treatment, and the feasibility of complete surgical removal. Benign tumors that can be fully resected often carry a favorable long-term prognosis. For malignant or metastatic tumors, outcomes vary considerably between individuals.

References

Leitlinienprogramm Onkologie (German Cancer Society, AWMF): S2k Guideline on Intracranial Meningiomas and Spinal Tumors, 2022.
Fehlings MG et al. - A clinical practice guideline for the management of patients with degenerative cervical myelopathy and spinal cord tumors. Spine, 2012.
World Health Organization (WHO): Classification of Tumours of the Central Nervous System, 5th Edition, 2021.

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