What it is
Tumors affecting the spine are either primary — arising from the bone, the nerves or the coverings of the cord — or secondary, having spread from elsewhere. They are uncommon, and they vary so widely in behavior that generalisations are of limited use.
Symptoms
- Back or neck pain that is present at rest and often worse at night
- Pain not related to activity or position, unlike most mechanical back pain
- Neurological change: weakness, numbness, difficulty walking, bladder change
- Unexplained weight loss, fever, or a known history of cancer
Night pain that wakes you, in someone with a cancer history, deserves imaging rather than reassurance.
How it is diagnosed
MRI with contrast is the primary investigation. CT assesses bony involvement and stability. Staging investigations look for a primary source where spread is suspected. A biopsy is usually needed before definitive treatment, because the tissue type determines what the right treatment is.
Non-surgical treatment
Depending on the tumor: radiotherapy, systemic treatment, or observation for benign lesions that are not causing problems. Many spinal tumors are treated effectively without an operation.
When surgery is considered
For spinal cord compression, mechanical instability, intractable pain from a structural problem, or to obtain tissue where a biopsy cannot. Dr. Long's role is usually the structural part — decompressing the nerves and stabilizing the spine — within a plan led jointly with oncology.