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Tumor lesions of the spine might be benign or malignant, and may be located in the neck, back, lower-back and coccyx.
Primary spinal tumors may originate from vertebral bones, soft tissues, or nerves. In contrast to adults, metastatic spinal tumors are rare in children.
What are the signs of spinal tumors?
- Localized pain that may also refer to other parts of the spinal column
- Night pain
- Spinal cord and nerve compression, if the tumor enlarges toward the spinal canal
- Numbness and/or weakness in the upper and lower extremities
- Difficulty walking
- Loss of appetite, weight loss, and sweating
How are spinal tumors diagnosed?
The diagnostic process should start with a detailed medical history and physical examination. X-ray, CT and/or MRI may be required to analyze the tumor. Scintigraphy or PET-Scan may also be required to check for the presence of distant metastasis.
A biopsy is necessary to definitively diagnosis a tumor. A fine needle of trocar biopsy may be performed by spinal surgeons or interventional radiology specialists under local or general anesthesia. Open biopsy may be preferred in some cases. The biopsy should be taken by the same team who will perform the definitive treatment.
What are non-surgical treatments options for spinal tumors?
For benign tumors that do not show signs of local aggressiveness or cause serious symptoms, observation is recommended. Observations should include frequent radiographic evaluation, generally done with MRI. For malignant tumors, options include chemotherapy and radiotherapy.
When is the surgery necessary for spinal tumors in children?
- When malignant tumors are when diagnosed in order to eliminate malignant cancer cells from the body immediately, or as soon as possible.
- Progressive neurologic deficit and loss of bowel/bladder control
- Instability—abnormal motion in a spinal segment due to disruption of the spinal bones and/or ligaments—may require surgical stabilization and fixation
- When the tumor does not respond to chemotherapy and radiotherapy
What are the surgical treatment options for spinal tumors in children?
- The tumors can be removed partially or completely. This decision is given based whether the tumor is benign or malignant, has spread, responds to chemotherapy or radiotherapy, and if there is a risk of neurologic compromise, etc.
- If the removal of the tumor will cause instability due to its size and location, instrumentation and stabilization may be required.
- Curettage and cement augmentation may be applied for some benign tumors where the cortex is well preserved.
- Chemotherapy and/or radiotherapy may be necessary after surgery for some tumor types.
How does the follow-up entail for children with spinal tumors?
The frequency and length of the follow-up period is determined by the type of tumor. Follow-up radiographic examination is generally done with X-ray or MRI. The risk of recurrence varies for different types of tumors.