Spine Tumor Treatment in Northern New Jersey

As New Jersey’s most comprehensive complex spine care center, the surgeons and medical team at Centers for Neurosurgery, Spine & Orthopedics (CNSO) routinely diagnose and treat spine disorders including spine tumors, using the most advanced technology. The quality of care at CNSO surpasses all others because patients have the benefit of receiving all their care in one location with doctors who share their patients’ medical updates on a daily basis. Some spine tumors require surgery while others do not. Find out more about the CNSO neurosurgeon led team comprised of orthopedic spine surgeons, pain management doctors, physical therapists, and radiation oncologists. Together CNSO will offer the latest and most appropriate surgical or non-surgical treatment plan based on the type of spinal tumor

Types of Spinal Tumors and Cysts of the Spine Treated at CNSO

A mass in the spine can either be a tumor, a cyst, or a deformed blood vessel called a hemangioma. Imaging can reveal which type of mass it is. By comparison to any other type of tumor in the body, the prevalence of spine tumors is rare. Spine tumors are broadly classified based on their location:

• Extradural tumors: Tumors that grow outside of the membranes that surround the spinal cord.
• Intradural tumors: Tumors that develop between the dura (the tissue covering the spinal cord) and the spinal cord itself.
• Intramedullary tumors: Tumors that grow in the cells of the spinal cord itself.

Depending on the location of the tumor, which is confirmed by an MRI study and symptoms, some tumors need to be urgently removed while others do not. Some types of tumors are more likely to be benign (noncancerous) while other tumors are only malignant (cancerous). The exact type of tumor can be confirmed by a specimen from the tumor. A pathologist will confirm the type of tumor via a histological study. Spine tumors can only be removed by a neurosurgeon. Examples of the most common spinal tumors as well as some very rare tumors, all of which are treated by CNSO neurosurgeons include:

Astrocytoma

When considering the most common spinal cord tumor, a spinal astrocytoma is at the top of the list. An astrocytoma is a type of tumor that forms within the glial cells, specifically the astrocyte cells, which predominantly comprise the brain and spinal cord neurological tissue. As with all tumors of the spine, an MRI is needed to confirm the existence of a spinal tumor because patients with an astrocytoma typically experience symptoms that could be caused by a tumor, a neurological disorder, or an anatomic spine structural disorder:

• Back pain
• Problematic sensory disfunction
• Weakness or loss of motor function
• Headaches
• Vomiting

Within the family of an astrocytoma, there are further subtypes. An example is a pilocytic astrocytoma of the spine. Because a pilocytic astrocytoma slowly grows, its mass will gradually inhibit the flow of cerebrospinal fluid which surrounds the spinal cord and brain. The obstruction of cerebrospinal fluid can lead to symptoms like headaches and vomiting due to the back up of CSF volume in the brain.

Meningioma of the Spine

This type of tumor occurs in the thin layer of tissue that covers the spine and brain called the meninges. Of all spinal tumors, a spinal meningioma is most common. Most meningiomas are benign. When a meningioma grows in the spine it most frequently develops in the cervical or thoracic region. The discovery of a spinal meningioma may occur incidentally if the patient has not yet developed symptoms. This type of tumor only needs to be removed if it is causing troublesome symptoms. Signs of a meningioma result from the tumor pressing on the spinal cord or surrounding nerves. These symptoms may include:

• Back, leg, or neck pain
• Muscle spasms
• Weakness of the extremities or loss of function
• Abnormal sensations or lack of sensations
• Trouble balancing

Spinal meningiomas occur more frequently in women than men. Risk factors for the development of a meningioma include:

• Exposure to radiation
• Certain hormones, such as estrogen
• Obesity
• Patients with neurofibromatosis 2 disorder (NF2)

Chondrosarcoma

Chondrosarcomas are slow-growing, malignant tumors that develop in cartilage and can occur throughout the spine. Symptoms may depend on where the tumor is growing. For example, if the tumor is located in the cervical spine near the base of the skull, patients may experience headaches or vision problems and arm weakness. Yet if the chondrosarcoma forms in the lower back, the patient will experience difficulty moving their legs.

Chordoma of the Spine

Chordomas are a rare type of malignant tumor that can grow anywhere along the spine. Because they put pressure on the spinal cord, they can cause symptoms such as numbness, weakness, or vision problems. Chordomas are more common in women than in men and may reoccur after treatment.

Ependymoma of the Spine

An ependymoma is an uncommon type of tumor that develops in the spinal cord or brain. It’s not clear what causes this kind of tumor, and symptoms can vary based on where the tumor is located. Symptoms of spinal ependymoma may include:

• Difficulty with balance
• Nausea, vomiting, or dizziness
• Numbness or weakness in the limbs

Patients with ependymoma of the spine require surgical removal of the tumor.

Intramedullary Cyst

A cyst is different from a tumor. A tumor is a mass of solid cells. A cyst is a fluid or tissue-filled sac that is generally not cancerous. Cysts can happen anywhere on the spine, although most are extradural. Intramedullary cysts are fairly uncommon. When a cyst develops on the spinal cord, a patient may experience symptoms such as back pain, numbness, or muscle spasms. Symptomatic cysts need to be removed.

Spine Schwannoma

Schwann cells are found inside the lining of the body’s nerves. These cells can develop benign tumors throughout the spine that are called schwannomas. Like many spinal tumors, symptoms can vary based on the schwannoma’s location. Patients may experience back pain, numbness, or a “pins and needles” feeling. Schwannomas can occur at any age, but most patients with this type of tumor are diagnosed between their 20s and 50s.

Neurofibroma in the Spine

Like Schwannomas, neurofibromas also develop in the Schwann cells. These nerve sheath tumors generally occur in patients who have a genetic condition called neurofibromatosis. However, patients without this condition can develop sporadic neurofibromas. While most neurofibromas are benign, they can cause problems if they are putting pressure on the spinal cord. Neurofibromas can affect arm and leg function and can cause numbness or pain.

Spinal Cysts

Dermoid and epidermoid cysts of the spine grow just below the skin’s surface. They can develop anywhere along the spine and are benign. An epidermoid cyst of the spine is a sac filled with skin cells. In contrast, a spinal dermoid cyst can contain blood, hair follicles, or other tissues in addition to skin cells. Some cysts are small and don’t cause any symptoms. They may even decrease in size over time.

Spinal Hemangioblastoma

A spinal hemangioblastoma is a rare type of vascular tumor that usually occurs on the spinal cord’s surface. Some patients may have a genetic predisposition to developing hemangioblastomas if they have a condition called Hippel-Lindau Disease. Patients with this genetic condition typically develop multiple hemangioblastomas in different parts of the body.

Symptoms of spinal hemangioblastoma can include:

• Numbness or weakness in the arms or legs
• Bladder or bowel function problems

Hemangioblastomas are benign and often grow slowly, so some patients may not notice any symptoms.

Diagnosing and Treating Spinal Tumors

Different types of spine tumors, as well as spine disorders and structural spine abnormalities, can cause similar neurologic and musculoskeletal symptoms. A physical exam and imaging can determine whether there is a tissue and whether a tissue sample would be necessary to pinpoint the type of tumor. In order to perform a thorough neurological evaluation, the CNSO medical team will utilize the following:

• Neurological examination: Different motor, strength, balance, and sensory examination tests to analyze the origin of the symptoms. This examination is done during the initial office visit and then compared at any subsequent office visits to determine the origin and status of the tumor or disease affecting the patient’s musculoskeletal or neurologic system.
• Imaging: X-rays, MRIs, and CT scans can help determine the location, size and most probable type of tumor or structural spine abnormality.
• Biopsy: When necessary, histologically analyzing a sample of tissue from a tumor will confirm the type of tumor and guide the future treatment plan.

Most types of spine tumors need to be surgically removed. The neurosurgeons at CNSO are highly skilled and employ minimally invasive techniques to remove spine tumors and correct structural spine abnormalities. By utilizing minimally invasive techniques, patients will more quickly and easily recover from spine surgery. If the surgical approach poses a risk of neurological damage, the CNSO team may recommend radiation therapy to irradicate the tumor cells. In either situation, routine monitoring for new tumor growth would be necessary.

Some types of benign tumors and cysts do not require surgical removal. If a tumor is small, slow-growing, and isn’t causing any symptoms, a doctor may recommend ongoing monitoring rather than surgery.

Schedule an Appointment at Centers for Neurosurgery, Spine & Orthopedics

At Centers for Neurosurgery, Spine & Orthopedics (CNSO), the board-certified team of Neurosurgery fellowships trained in spine surgery are committed to helping each patient achieve the best health outcome possible. CNSO’s experienced medical team serves communities throughout NJ, at multiple convenient locations for outpatient care in Bergen, Passaic, Essex, Morris, and Hudson counties. To learn more about the diagnosis and treatment options for spine tumors, contact CNSO today.