Brandon Lucke

Wold MD, PhD, MCTS; University of Florida, Neurosurgery, USA

Abstract

The prevalence of spinal tumors is rare in comparison to brain tumors which encompass most CNS tumors. Tumors of the spine can be divided into primary and metastatic tumors with the latter present in the majority of spine cancer patients. Primary tumors are further subdivided based on their location on the spinal column and in the spinal cord into intradural intramedullary, intraduralextramedullary, and primary bone tumors.

Back pain is a common presentation in spine cancer patients. Other radicular signs may also be present. MRI is the imaging modality of choice for intraduralextramedullary and intradural intramedullary tumors. Plain radiographs are used in the initial diagnosis for primary bone tumors while CT and MRI may often be necessary for further characterization. Complete surgical resection is the treatment of choice for spinal tumors and may be curative for well circumscribed lesions.

However, intralesional resection along with adjuvant radiation and chemotherapy can be indicated for patients that would experience increased morbidity from damage to nearby neurological structures caused by resection with wide margins. Even with the current treatment options, the prognosis for aggressive spinal cancer remains poor. Advances in novel treatments including molecular targeting, immunotherapy and stem cell therapy provide the potential for greater control of malignant and metastatic tumors of the spine.