Spinal Tumours

What is this condition?

Spinal tumours may arise in the vertebrae, outside the dura, inside the dura but outside the cord, or within the spinal cord. They include benign nerve-sheath tumours and meningiomas, primary bone/cord tumours and metastases. The compartment, pathology, stability and neurological effect determine treatment.

What symptoms can it cause?

• Persistent focal pain, often at night or unrelated to activity
• Band-like trunk pain or radiating limb pain
• Progressive weakness, numbness, gait or hand dysfunction
• Bladder/bowel change, weight loss or known cancer history

How is it assessed and diagnosed?

Contrast MRI of the relevant spine is central and sometimes whole-spine imaging is required. CT evaluates bone destruction and surgical planning. Body imaging, blood tests, tumour markers or image-guided biopsy may identify a primary cancer. Neurological decline can make this an emergency before pathology is fully known.

Treatment without surgery

Steroids may be used urgently for selected metastatic cord compression under specialist direction. Radiotherapy, systemic cancer treatment, antibiotics for infection mimics, pain care and bracing are chosen by pathology and stability. Some benign incidental tumours can be monitored.

When is surgery or a procedure considered?

Surgery is considered for progressive deficit, mechanical instability, uncertain diagnosis, radioresistant disease, severe compression or a removable benign tumour. The operation may be biopsy, decompression, tumour removal and/or stabilisation. Intramedullary tumours require specialised microsurgery and often monitoring because the cord itself is involved.

Treatment and procedure options

• Observation for selected stable benign lesions
• Image-guided biopsy
• Microsurgical intradural or intramedullary surgery
• Decompression and stabilisation for vertebral/metastatic disease
• Radiotherapy, radiosurgery and systemic oncology treatment

Risks from the disease and from treatment

Untreated compression can cause irreversible paralysis and bladder loss; unstable vertebrae can collapse. Treatment risks include neurological worsening, CSF leak, bleeding, infection, instability, incomplete removal and recurrence. Cancer prognosis and goals of care shape proportional treatment. No procedure is risk-free. General risks include anaesthetic problems, bleeding, infection, blood clots and delayed healing. Neurological risks depend strongly on the exact structure being treated and may include new weakness, numbness, speech or vision change, seizure, cerebrospinal-fluid leakage, need for another procedure or failure to obtain the hoped-for relief. The surgeon should discuss the risks that apply to the individual case.

Recovery and follow-up

Rehabilitation and pathology-led follow-up are essential. Benign tumours may need serial MRI; malignant disease requires oncology coordination. Functional recovery depends on how long and how severely the cord or roots were compressed. Recovery is not judged only by the first few days. Pain control, wound care, nutrition, safe mobilisation, physiotherapy and planned follow-up all matter. Some symptoms improve quickly after pressure is relieved; others recover gradually over weeks or months, and permanent nerve injury may not fully reverse.

Preparing for your consultation

Bring the original MRI/CT images or digital files, written reports, previous prescriptions, a current medicine list, and any operative or pathology records. For sudden warning symptoms, use the nearest emergency department rather than waiting for a routine appointment.

Authoritative patient-information sources

• AANS — Spinal Tumors: https://www.aans.org/patients/conditions-treatments/spinal-tumors/