Tumors of the spine and spinal cord are relatively uncommon. Spinal cord tumors can be either primary (originating in the spinal cord) or secondary (metastases of cancer that originated elsewhere in the body).
Pain can sometimes be a symptom of a spinal tumor. Therefore, the challenge is to determine how to evaluate back or neck pain with the goal of specifically excluding a tumor as the cause of the pain.
The majority of spine tumors will present with pain. Pain symptoms that continue to get worse despite treatment, and that may be associated with other symptoms such as fatigue or weight loss, may suggest that a tumor or a cancer is responsible. The pain may be worse at night, and not necessarily be related to level of activity. Pressure on nerve roots that exit the spinal cord can cause pain, numbness, tingling and weakness while pressure on the cord itself can cause spasticity and decreased or abnormal sensations. When associated with neurological symptoms such as loss of bowel and bladder control or pain running down your legs, further evaluation is clearly warranted. Be aware of other physical symptoms, such as lumps and bumps, moles on your skin, and any other findings that might suggest that you have a tumor somewhere else in your body.
Many spine tumors are found as part of a routine diagnostic evaluation for neck pain. This begins with a complete physical exam. If you have concerns that you may have cancer elsewhere, you should discuss this with your spine surgeon, who can help you make sure that you are getting the right tests. X-rays of your neck are often the initial step in the imaging process. X-rays are a very good way to look at the spine, but they are not foolproof. While many tumors will be visible on regular x-rays, some are much more difficult to see. This is especially true for those cancers involving the soft tissues such as the spinal cord itself or the muscles that surround the spine. When there are reasons to suggest that a cancer may be the cause of neck pain, doctors will usually order a bone scan, a CT scan, or a MRI. The combination of a history and physical exam, and the appropriate imaging studies will find or exclude the majority of spinal tumors.
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