Vertebral tumor

Diagnosis

The signs and symptoms of vertebral tumor may resemble other conditions which are more common. Hence, it is vital to inform the doctor thorough medical history together with physical and neurological assessment.

The following tests are done if the doctor investigates for vertebral tumor.

• Spinal Magnetic Resonance Imaging (MRI). Uses a strong magnetic field and radio waves to present clear images of the spine, spinal cord and nerves. It may also be done without or with a contrast agent injection for a more specific view of the tissues and structures.
• Computerized Tomography (CT) scan. A narrow radiation beam is use to produce a more detailed images of the spine. A contrast agent may also be used during this procedure or it may be combined with MRI.
• Biopsy. A small suspected tissue sample is extracted and examined under a microscope to make a diagnosis and plan for future management. In most cases, radiologist will perform fine-needle biopsy under a guidance of X-ray or CT scan. An imaged-guide needle biopsy helps to locate tumor more precisely.

Treatment

Doctors need to take into consideration of the patient’s age, general health, tumor type and if the tumor is primary or has metastasized to the spine from other parts of the body. The treatment goal is to remove the vertebral tumor but there are risk of complications that need to be considered such as permanent damage to the spinal cord or nerves.
These are the treatment options available:

• Monitoring. Vertebral tumors may be found asymptomatic. The tumors then need to be closely observed and imaging such as CT scan or MRI must be done. If they are still small, and non-cancerous, no intervention is needed especially if the surgery is high risk for the patient
• Surgery.  The most common treatment for vertebral tumors is surgical removal with bearable spinal cord or nerve injury risk. Microscopic surgery is used to carefully taken out a tumor from normal tissues. Surgical injury may be minimized by checking the spinal cord and nerve functions. Ultrasound may also be used to destroy tumors and remove fragments during the surgery. Not all of the tumor may be removed by surgery even with all the technological innovations. Radiation or chemotherapy or both may sometimes be used after the surgery to eliminate the remaining tumor.
• Radiation therapy. After surgery there may be residual tumor left, radiation therapy uses to destroy the remaining tumors that cannot be surgically removed. If surgical treatment of tumors are too dangerous or cannot be perform, radiotherapy can be an option.
  It may also be the first choice of treatment for some late stages of vertebral tumors to help relieve pain or decrease size of tumor where surgery can be done after that.
  The radiation treatment may be altered by adjusting the radiation dosage or by utilizing a 3-D conformal radiation therapy based on your condition to ensure its effectiveness and avoid destroying nearby structures. Certain types of vertebral tumors such as chordomas, chondrosarcomas and some cancers that occur during childhood can be treated by a proton beam therapy which particularly delivers radioactive protons to the tumor. This technique avoid damaging the healthy structures around the tumor unlike the regular radiation treatment.
• Chemotherapy. Utilizes medications to kill cancer cells or stop their growth. It is the standard treatment for many cancer types. Chemotherapy can be given alone or combination with other therapy.
• Other drugs. The spinal cord may be inflamed from surgery, radiation therapy or even just the existing tumors, therefore, corticosteroids may be prescribed by the doctor to decrease swelling after surgery or while undergoing radiation therapy. Corticosteroids can make serious side effect such as osteoporosis, diabetic and muscle weakness.