Spinal Tumors | Causes and Risks

“What causes spinal tumors?” is a common question for those diagnosed with these abnormal growths in or around the spinal column. Spinal tumors can be scary and confusing, but understanding the various causes can help patients better grasp their condition.

Spinal tumors arise from abnormal and uncontrolled cell growth in or near the spinal column, which contains the spinal cord, nerves, tissues, bones, and fluid. Both cancerous (malignant) and noncancerous (benign) tumors can develop in the spine. These growths may originate directly within the spine itself, known as primary spinal tumors, or spread from cancers elsewhere in the body, called secondary metastatic spinal tumors.

While many causes of spinal tumors remain uncertain, research has uncovered key genetic conditions, environmental exposures, and other risk factors that contribute to these growths.

Types of Spinal Tumors

Spinal tumors can be categorized as primary (starting in the spine) or secondary (metastatic, spreading from elsewhere). Secondary tumors are more common.

Benign spinal tumors are noncancerous, while malignant tumors are cancerous. Benign tumors tend to have slower, less invasive growth and clearer borders.

Some major spinal tumor types include:

• Astrocytomas – Develop from spinal cord cells
• Chordomas – Malignant sacral tumors from embryonic remnants
• Ependymomas – Derived from lining of spinal fluid cavities
• Gliomas – Broad category encompassing spinal cord tumors
• Hemangioblastomas – Benign vascular tumors
• Meningiomas – Benign but sometimes symptomatic tumors of the spinal membrane
• Neurofibromas and Schwannomas – Grow from peripheral nerve cells
• Lymphomas – Malignant lymphocytes in the spinal cord
• Hemangiomas – Benign vascular tumors inside vertebrae

In overview, spinal tumors vary by cell of origin, region affected, degree of malignancy, and other factors that guide prognosis and treatment planning.

Causes and Risk Factors

Unraveling the intricate reasons why spinal tumors develop constitutes an area of ongoing research. Scientific studies and clinical observations have revealed various contributing genetic, environmental, and general risk factors.

Genetic Causes and Inheritance Patterns

In some cases, genetic mutations passed down in families lead to spinal tumor growth at increased frequencies. Understanding common hereditary conditions offers vital clues into their pathogenesis.

Neurofibromatosis Type 1

Neurofibromatosis type 1 (NF1) occurs due to mutations in the NF1 tumor suppressor gene on chromosome 17. Loss of the gene’s neurofibromin protein enables excessive cell proliferation. Diagnosis typically occurs in childhood.

Neurofibromatosis Type 2

Mutations in the NF2 gene on chromosome 22 cause neurofibromatosis type 2 (NF2). Loss of merlin protein unleashes tumor development, usually affecting both auditory nerves and the spine by early adulthood.

Schwannomatosis

Research links schwannomatosis with mutations in SMARCB1 or LZTR genes, which normally suppresses tumors. Multiple schwannomas characterize this disorder, occurring after age 30 on average.

Von Hippel-Lindau Disease

Von Hippel-Lindau disease (VHL) is a multisystem disorder whereby a mutation in the VHL gene allows angiogenesis and tumor growth in the central nervous system, spine, and organs like the kidneys.

Inheritance Patterns

The above conditions demonstrate autosomal dominant inheritance, meaning only one flawed copy of the involved gene must be inherited from a parent to confer disease risk. Anyone with a family history of these syndromes may consider genetic testing.

Other Risk Factors

Aside from hereditary factors, other influences raise spinal tumor susceptibility as well.

History of Cancer (Metastasis Risk)

Possessing a personal cancer diagnosis constitutes the most prominent risk factor for developing secondary metastatic spinal tumors. Breast cancer, lung cancer, prostate cancer, multiple myeloma, and lymphoma often spread to the bone through metastasis. Remaining vigilant about new-onset back pain with an existing malignancy is key.

Compromised Immune Status

Some people with impaired immune function face higher odds of forming spinal lymphoma growths. The reasons are not fully clear but may involve inability to regulate aberrant cell divisions.

Ionizing Radiation

Exposure to ionizing radiation from sources like x-rays or radiation therapy slightly elevates spinal tumor chances. Radiation can damage DNA and disrupt orderly cell lifecycles.

Chemical Exposures

Links exist between development of certain spinal tumor types and exposure to chemicals like pesticides or petroleum products. Further research must solidify evidence for which agents inflict damage.

Unknown Causes

Despite the known contributors above, many spinal tumors have elusive, not-yet-defined causes. The complex biology enabling these growths to form provides ongoing investigation opportunities.

Symptoms and Complications

By compressing or invading spinal nerves and tissues, spinal tumors give rise to an array of concerning symptoms and multi-system effects. Recognizing characteristic signs facilitates prompt evaluation and diagnosis.

Common Symptoms

Spinal tumors share several hallmark symptoms, including:

• Persistent, progressive back pain often worse at night
• Radiating pain into the legs or arms
• Numbness, tingling, or generalized neuropathic pain
• Muscle weakness affecting mobility
• Urinary or bowel incontinence

If experienced, seeking rapid medical assessment is crucial even before a spinal tumor is suspected. Catching spinal problems early on grants more flexibility in management.

Nervous System Complications

By disrupting delicate spinal nerve structures, tumor-related neurological deficits may emerge such as:

• Loss of sensation
• Difficulty walking progressing to falls/imbalance
• Poor coordination
• Muscle wasting/paralysis

On-time therapy aims to preserve existing nervous system function and prevent additional impairment related to compressive damage.

Effects on Bodily Structures

Depending on tumor specifics, various organs and anatomical systems endure collateral complications like:

• Spinal deformities such as scoliosis
• Bone weakening or fractures
• Vision loss from optic nerve involvement
• Cardiovascular issues like high blood pressure
• Kidney dysfunction
• Hormone dysregulation

Keeping tabs on systemic signs alongside nerve symptoms facilitates comprehensive management.

Diagnosis and Testing

If spinal tumors are suspected, doctors use various tests to diagnose them. These confirm tumor presence, type, location and degree of progression. Multiple modalities help characterize key tumor traits.

Imaging Tests

Various advanced imaging techniques allow detailed visualization of anatomical structures potentially disturbed by tumors. Common modalities include:

• X-rays – Assess spinal alignment and stability along with bone integrity. Can detect erosions implicating metastases.
• CT scans – Provide bony insight with 3D reconstructions and show calcifications.
• MRI scans – Define soft tissue spinal tumors and discern effects on nerves or cord through enhanced resolution.

Ordering the appropriate imaging for individual presentations is key.

Biopsies

Needle or surgical biopsies involving tumor sample extraction help pathology specialists distinguish between tumor types via microscopic analysis. Biopsies establish dignity to guide prognosis and treatment protocols.

Genetic Testing

Blood tests screening for gene mutations linked to heritable conditions like neurofibromatosis syndromes and VHL provide etiological clarity.

Supplementary testing clarifies symptoms or monitors for complications. Examples include:

• EMG testing electrical nerve conduction
• Lab tests evaluating biomarkers related to bone, hormones, blood counts, and so on
• Neurocognitive testing for memory, balance, coordination

Treatment and Management

Available treatments for spinal tumors span a range depending on multiple factors, but all focus on restoring quality of life and nervous system function.

First line management often starts with medications to reduce pain and inflammation, such as glucocorticoids, over-the-counter analgesics, and anticonvulsants for neuropathic symptoms. Supportive options like occupational therapy or assistive walking devices may also be enlisted early on.

For rapidly worsening presentations, urgent surgical decompression prevents further deficits secondary to compressive injury to the spinal cord or emerging nerve roots by physically resecting tumor bulk. Techniques like minimally invasive spine surgery quicken recovery times.

Prevention

Unfortunately, preventing most spinal tumors is quite difficult with current knowledge. Random DNA changes lead to unpredictable growths forming in the spine itself. Staying alert to new symptoms offers the best shot at early detection.

For spinal tumors that spread from other sites, preventing metastasis isn’t fully possible if cancer already exists elsewhere. However, we have strategies to reduce risks. After surgery removes a tumor, adjuvant chemotherapy or radiation therapy mop up stray cancer cells before they can spread. Follow-up scans catch any recurrences early too.

Though spinal tumor prevention has challenges, better understanding of these diseases and advancing treatments aim to lower risks over time through enhanced awareness and innovation.

Conclusion

The spine’s intricate structure makes it vulnerable to tumor growth, spread from elsewhere, and damage to surrounding areas. Researchers have long wanted to understand what exactly causes spinal tumors to develop. Important factors involve genetics and environmental exposures. Ongoing studies are revealing more about these triggers.

Symptoms and outlook depend greatly on the tumor type, spine location, size, and effects on nerves. Thorough workups are crucial, using tissue studies, scans, and genetics to know how to best treat each tumor.

By continually improving scientific insight into what sparks tumor development and growth, better diagnosis and treatment options emerge. This dramatically brightens the future for those facing a spinal tumor finding. Even in very complex cases, teams now have more tools to optimize longevity and day-to-day function.