Types of Spinal Cord Tumors

The spinal cord is a long bundle of nerves that runs from the base of the brain down to the lower back. It serves as a crucial part of the central nervous system by transmitting signals between the brain and the rest of the body. Spinal cord tumors that compress or disrupt this information highway can cause a variety of symptoms.

Spinal cord tumors can be classified into 3 main types on the basis of location of the tumor in relation to the spinal cord and its protective covering (dura). These type names can sound confusing, but they are straightforward if you remember that the prefixes “intra” and “extra” mean “inside” and “outside,” respectively, and “medullary” pertains to the inner part of a structure. The following are some spinal tumor types with their corresponding locations.

• Intramedullary tumors arise within the spinal cord tissue itself; common types include ependymoma, astrocytoma, and hemangioblastoma
• Intradural-extramedullary tumors develop within the dura but outside of the actual spinal cord tissue; common types include meningioma, schwannoma, and neurofibroma
• Extradural tumors are located outside of the dura and usually result from the spread (metastasis) of cancer from another part of the body to the spinal cord; various types, such as cancer of the lung, breast, prostate, and kidney cancer, can metastasize to the spinal cord

Extradural tumors are the most common type of spine tumor and account for approximately 60% of all spinal tumor cases, followed by intradural-extramedullary (30%) and intramedullary (10%) tumors. Although a spinal cord tumor is a serious matter, its behavior can range from being slow-growing and benign to rapidly spreading and malignant. Glioblastoma if often considered the most malignant type of spinal cord tumor because of its aggressive behavior and the poor prognosis in those who have it.

Spinal cord tumors can be further distinguished by the specific type of cell that makes up the tumor. The following are common spinal cord tumor types.

Gliomas are tumors that develop from glial cells that support, protect, and nourish nerve cells (neurons). Glial cells closely interact with neurons and therefore are found within the spinal cord. Because of the abundance of glial cells within the body, gliomas are the most common type of intramedullary spinal cord tumor. There are different types of glial cells, each with specific functions. Common glioma types that affect the spinal cord include astrocytoma and ependymoma.

• Astrocytomas arise from astrocytes, which are star-shaped cells that help provide structural support, regulate chemical balance, supply nutrients, and ensure proper functioning of the nervous system
• Ependymomas arise from ependymal cells, which are specialized cells that line the fluid-filled spaces of the central nervous system and help produce a watery substance (cerebrospinal fluid) that cushions the brain and spinal cord

Meningiomas are slow-growing tumors that develop from the protective membranes that cover your spinal cord (meninges). These tumors appear more commonly in the upper back and in women aged 40 years or older, and they most commonly appear as intradural-extramedullary tumors.

Nerve sheath tumors are a group of tumors that arise from cells that form the protective covering (sheath) around the nerves. These tumors can develop along any nerve outside of the brain and spinal cord (peripheral nerve). Nerve sheath tumors can affect the initial segment of a spinal nerve as it branches out from the spinal cord (nerve root). Similar to meningiomas, they typically arise as intradural-extramedullary tumors.

• Schwannomas are benign tumors that originate from Schwann cells, which are responsible for supporting and insulating nerve fibers and typically grow slowly; although most are not cancerous, they can in rare cases become malignant
• Neurofibromas are tumors that originate from a mix of cells, including Schwann cells, fibroblasts, and other cell types found on peripheral nerves; the development of neurofibromas can result from a genetic disorder called neurofibromatosis type 1 (NF1) (people with NF1 often develop multiple neurofibromas throughout their lifetime)

Spinal cord tumors, similar to other tumors in general, can also be classified as benign (not cancerous) or malignant (cancerous). Whereas benign tumors typically grow slowly and stay in one location, malignant tumors can grow rapidly and spread (metastasize) to other parts of the body.

Developing a tumor anywhere in your body is a situation that needs to be evaluated by a healthcare professional as soon as possible. This is particularly true for spinal cord tumors, because prolonged compression or infiltration of the spinal cord by the tumor could cause permanent neurological damage. The following are ways in which spinal cord tumors can cause injury.

• Compression of the spinal cord: Tumors growing within or near the spinal cord can compress the spinal cord itself, which can interfere with the normal functioning of the spinal cord and lead to symptoms such as weakness, sensory changes, or difficulties with bowel and bladder function. If the compression is severe and not treated promptly, it can result in permanent spinal cord damage.
• Invasion of the spinal cord: Some tumors, particularly aggressive or malignant types, might invade the neighboring spinal cord tissue and permanently impair neurologic function. As the tumor infiltrates the spinal cord, it can become difficult to completely remove by surgery.
• Disruption of blood supply: Tumors can disrupt the normal blood supply of the spinal cord and lead to a lack of sufficient flow of oxygen to spinal cord tissues (ischemia) and loss of proper functioning.

Depending on the location of the spinal cord tumor, compression of the spinal cord can be life-threatening. For example, a tumor located in the neck region can affect the nerves controlling the muscles involved in breathing, which is a medical emergency and requires immediate attention.

If you are experiencing sudden or rapid deterioration in neurological function, such as severe weakness or paralysis, loss of sensation, or significant changes in bowel or bladder control, it is important to seek medical evaluation right away. Time is of the essence in addressing spinal cord–related emergencies to minimize the risk of permanent damage and ensure appropriate and timely medical intervention.

• Spinal cord tumors grow within or around the spinal cord and can be classified as intramedullary, intradural-extramedullary, or extradural
• Metastases, gliomas, meningiomas, and neurofibromas are among the most common types of spinal cord tumors
• Spinal cord tumors can cause permanent neurologic deficits if severe spinal cord compression is not addressed promptly

• American Association of Neurological Surgeons (AANS): Spinal tumors
• National Cancer Institute: Related organizations
• Cancer Support Community: Brain and spinal cord tumors
• Glioma Foundation Center
• Collaborative Ependymoma Research Network (CERN) Foundation