Understanding the Different Locations of Spinal Tumors

Spine tumors are abnormal masses of tissue that develop anywhere on the spine. They can grow on your spinal column (vertebrae), along the central nerve network housed inside your spinal column (spinal cord), or within the protective tissue layers surrounding your spinal cord (meninges).

Diagnosing spinal tumors can be challenging: They’re relatively rare and tend to grow slowly, often causing a mixed set of nonspecific symptoms, such as chronic back pain, radiating leg or arm pain, and muscle weakness or stiffness. 

At his practice in South Miami, Hialeah, and Weston, Florida, fellowship-trained neurosurgical oncologist Jose Valerio, MD, combines sophisticated imaging techniques and comprehensive medical evaluations to diagnose spine tumors promptly and accurately, so he can develop an effective and timely treatment plan. 

Here, he discusses basic facts about spinal tumors, including their possible locations.  

Basic facts about spinal tumors 

Spine tumors are masses of abnormal cells growing on, within, or around the spinal cord and/or spinal column. These cells multiply and accumulate without restraint, seemingly uncontrolled by the mechanisms that regulate normal, healthy cells. 

A spinal tumor can be noncancerous (benign) or cancerous (malignant). All spine tumors are classified as primary or secondary depending on how they originate: A primary spine tumor starts in the spinal column or cord, while a secondary spinal tumor is the product of a cancer that has metastasized from another site and spread to the spine.  

Secondary tumors account for about 97% of all spinal tumors. Research shows that 30-70% of people with cancer experience metastasis to their spine. Lung, breast, and prostate cancers are primary cancers that commonly spread to the spine. Primary spinal tumors are rare, and most are benign. 

The different locations of spinal tumors

Spinal tumors are defined by both the region of the spine in which they occur and their location within the spine itself. 

Regional locations

The four regions of your backbone are:]

• Cervical spine (neck)
• Thoracic spine (upper to mid-back)
• Lumbar spine (lower back)
• Sacrum (bottom of the spine)

Although they can appear in any section of spine, tumor occurrence is most common in the thoracic and lumbar spinal regions.  

Specific locations

Spine tumors are also identified by their specific location within the spine.  

Intradural-extramedullary 

These spinal tumors occur inside one of the three protective membranes (meninges) that envelope the spinal cord, but outside the spinal cord itself. Intradural-extramedullary masses are the second most common spine tumor, accounting for about 2 in 5 (40%) of all abnormal spinal growths. 

Like all tumors, intradural-extramedullary growths are characterized by the type of cell they arise from. Meningiomas, for example, are common intradural-extramedullary tumors that arise from the arachnoid membrane. Schwannomas, neurofibromas, and filum terminale ependymomas are other common intradural-extramedullary tumor types. 

Although intradural-extramedullary tumors are often benign, they can be difficult to remove if they’re close to fine neural structures. Some benign intradural-extramedullary tumors tend to recur over time, while others may become malignant over time.  

Intramedullary 

As the least common abnormal spinal growth, intramedullary masses occur inside the spinal cord and account for less than 1 in 100 (about 5%) of all spine tumors. Most of these growths derive from ependymal cells that form a continuous epithelial sheet (ependyma), which lines the central canal of the spinal cord. 

Astrocytomas and ependymomas are the most common intramedullary tumors. While they’re often benign, they can be difficult to remove. 

Extradural 

Extradural spine tumors are in the epidural space of the spinal column, or the area outside the spinal cord and its protective covering. Also called epidural tumors, these masses may involve the vertebrae (spinal bones). Extradural tumors are the most common abnormal spine growths, accounting for more than 1 in 2 (55%) of all spinal masses.  

Extradural spine tumors are usually secondary tumors caused by metastatic cancer. Lung, breast, and prostate cancers are the top primary cancers that spread to the bony part of the spine. Other primary cancers that can metastasize to the spine include leukemia, lymphoma, sarcoma, melanoma, multiple myeloma, and kidney, thyroid, and gastrointestinal cancers.   

Spinal tumor treatment options

Spinal tumor treatment is a highly individualized process that depends on the tumor’s location, size, and type, as well as the presence and severity of any symptoms. 

Primary spine tumors

For a primary spinal tumor that’s causing symptoms, Dr. Valerio usually recommends spine surgery to remove it. When performing spine surgery, he uses the most advanced tools and minimally invasive techniques for the best possible outcome. For example, he can use gamma knife radiosurgery or even stereotactic radiosurgery, which is a type of noninvasive radiation that shrinks a primary tumor without incisions.

Secondary spine tumors 

When treating a metastatic spinal tumor, Dr. Valerio’s primary objectives are to alleviate pain, maintain spinal and spinal nerve function, and improve the quality and length of your life. This may include chemotherapy or radiation therapy. Surgery is typically reserved for secondary spinal tumors that don’t respond well to radiation or chemotherapy.    

To learn more about spine tumor evaluation or treatment, book an appointment over the phone with the practice of Jose Valerio, MD, today.