Identifying the Symptoms of a Spinal Cord Tumor
Spinal cord tumors can mimic symptoms caused by other, more common, spine conditions such as those that come with age, overwork, or accidents like a fall. Nevertheless, a tumor growing on or near the spinal cord requires comprehensive examination by a dedicated care team. This article aims to help you understand how a spinal cord tumor can cause different symptoms depending on its location, size, and type.
What Are Spinal Cord Tumors?
Spinal cord tumors are abnormal growths of tissue that develop within or near the spinal cord. They can be classified by their location relative to the spinal cord as follows:
- Intramedullary tumors are found within spinal cord tissue and originate from cells inside the spinal cord; common types include astrocytoma and ependymoma
- Intradural-extramedullary tumors develop within the protective covering of the spinal cord (dura) but outside of the spinal cord itself; examples include meningioma and nerve sheath tumors such as schwannoma and neurofibroma
- Extradural tumors grow outside of the spinal cord and dura mater; they can originate from structures surrounding the spinal column (such as bones and soft tissues) or from a cancerous tumor that has spread to the spine from another part of the body (metastasis)
These tumors can also be categorized on the basis of the cell type of origin, such as meningioma, astrocytoma, or ependymoma. In addition, they are assigned a grade that reflects the degree of abnormality observed in the tumor cells when examined under a microscope. Lower-grade tumors tend to have a slower growth rate, whereas higher-grade tumors are more aggressive, with rapid growth and a greater potential to spread to other areas of the body.
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Symptoms of a Spinal Cord Tumor
Tumors that grow in the spinal cord can cause various symptoms depending on their location and size. The timing and manifestation of symptoms can be influenced by factors such as age, medical history, and the tumor’s growth rate.
Pain
The most common symptom of a spinal tumor is neck or back pain. The location of pain depends on the general location of the tumor. The spine is divided into the cervical, thoracic, lumbar, and sacral segments, which refer to the uppermost, middle, lower, and lowest parts of the spinal column, respectively. A cervical spine tumor can cause pain in your neck, whereas a thoracic spine tumor can cause pain in your midback.
However, you cannot physically sense a spinal cord tumor in the same way that you can feel an object in the palm of your hand. Spinal tumor pain can be difficult to distinguish from back pain that occurs from other causes. It may feel dull, deep, and throbbing, but this pain can differ from one person to another. Unlike pain from other conditions or diseases, back pain caused by a spinal cord tumor might be present throughout the day and night, unrelieved by rest or pain-relief medication and can worsen over time.
Back pain caused by a spinal cord tumor can seem to be more pronounced at night. The cause of this increased pain could be a result of pressure exerted on the back while lying in certain sleeping positions, an absence of distractions to take your mind off of the pain, or persistent inflammation from the tumor contributing to heightened pain sensations. In addition, the body naturally exhibits a lower level of inflammation-reducing steroid hormone at night, which can further intensify the discomfort.
As the tumor grows, it can press on nerves that branch out from the spinal cord, causing sharp, shooting pain in skin from which the nerve receives information (which is called radicular pain). This pressure can lead to a shock-like sensation that travels down your arms or legs. The pain can vary dramatically from being mild to severe.
Motor Problems
Spinal cord tumors can cause weakness or paralysis in the arms, legs, or other parts of the body, which can affect coordination, balance, and fine motor skills. Some people with such a tumor have difficulty walking and become clumsy.
Sensory Changes
Spinal cord tumors can disrupt the normal transmission of sensory signals from the skin to the brain, leading to changes in how we perceive sensations. This disruption can create the perception of abnormal sensations such as numbness and tingling.
Bowel and Bladder Dysfunction
Spinal cord tumors can affect nerves that control bowel and bladder function, especially if the tumor is located at the end of the spine near the tailbone, which can lead to lack of control (incontinence) or difficulty urinating and constipation.
Sexual Dysfunction
Spinal cord tumors can interfere with sexual function, causing changes in libido, erectile dysfunction in males, or problems with orgasm.
Symptoms of Benign and Metastatic Spinal Tumors
Both benign and metastatic spinal tumors can cause back pain and neurologic changes such as weakness, sensory abnormalities, and bowel and bladder dysfunction. However, people with a metastatic spinal tumor might also have symptoms related to their primary tumor and the burden of advanced cancer, including severe fatigue, weight loss, appetite changes, or muscle wasting.
Do All Spinal Cord Tumors Cause Symptoms?
Not all spinal cord tumors result in symptoms. Smaller, slow-growing tumors might not cause any symptoms at all. Such tumors can take years to develop, and the first symptom might be mild back pain, which could be dismissed as normal age-related wear and tear. In many cases, benign slow-growing tumors are found incidentally in routine imaging for an unrelated issue.
Key Takeaways
- Spinal cord tumors can be classified by their location relative to the spinal cord (for example, intramedullary, extramedullary-intradural, extradural) and along the spinal column (for example, cervical, thoracic, lumbar, sacral)
- Back pain is the most common symptom of a spinal cord tumor
- Spinal cord tumors can also cause weakness, sensory abnormalities, bowel or bladder dysfunction, and balance problems
Resources
- American Association of Neurological Surgeons (AANS): Spinal tumors
- Canadian Cancer Society (CCS): Supportive Care for Brain and Spinal Cord Tumors
- National Cancer Institute: Related organizations
- Cancer Support Community: Brain and spinal cord tumors
- Glioma Foundation Center
- Collaborative Ependymoma Research Network (CERN) Foundation