|
The spinal column is the most common bony location for cancer metastases. Due to the very extensive blood supply to the spinal column vertebrae, the spine is often the site of cancer spreading from its primary location. The vast majority of cancer involving the spine comes from other primary tumors such as lung, breast, prostate, thyroid and gastrointestinal tumors. Patients who have a primary cancer diagnosis who experience persistent symptoms of cervical (neck), thoracic (mid back) or lumbar (low back) pain, need to be evaluated for the possibility of spinal involvement of the tumor. At times, the cancer may cause the spinal vertebrae to collapse and may cause pressure on the spinal cord or nerve roots which in turn may result in weakness, extremity pain or progressive paralysis. The goal of treatment of spinal metastatic disease is to decrease pain, prevent neurolgic injury (paralysis) and help patients maintain ambulation.
Several diagnostic tests may be used to detect possible spinal tumors:
Magnetic Resonance Imaging (MRI): An MRI of the spine constructs a three-dimensional image of the spinal cord, nerves, and bones using a magnetic field and radio frequency technology.
Computed Tomography (CT): A CT scan produces cross-sectional images of the spine using X-ray equipment that rotates around the body to capture detailed images of the spine and its elements.
Myelogram: A dye is injected into the spinal column and detected using an X-ray or CT scan to identify compressed spinal nerves.
Bone Scan/ Pet Scan: These are tests where different contrast agents are injected followed by a scan that either looks at areas of bone destruction or areas of tumor activity.
Biopsy: If a growth is detected, a biopsy of the tissue may be taken and examined to determine if the tumor is cancerous or benign. Should the biopsy indicate that a spinal tumor is cancerous, a biopsy can be used to determine the cancer’s grade.
Should the diagnostic tests confirm the existence of a cervical, lumbar, thoracic, or sacrum spine tumor, treatment is structured around the threat the tumor poses to the integrity of the spine, as well as the physical condition of the patient. Treatment of most metastatic spinal tumors is not surgical. Many patients may respond well to systemic treatment such as hormone treatment or chemotherapy. Radiation therapy is also used to shrink tumor size at the radiated area and may help in controlling the pain.
Spinal surgical intervention for patients with metastatic disease to the spine is generally reserved for patients with spinal cord or neurologic compression that is causing progressive weakness. Patients who do not respond to systemic treatment and radiation and who have resistant tumors may also benefit from spinal surgical intervention to prevent vertebral collapse, preserve ambulation and decrease pain. As spinal surgical techniques continue to improve, patients suffering from spinal involvement from their tumor, may have surgical options that can increase their quality of life. |
