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Spinal tumors rarely occur and are either benign or malignant. Some tumors are known to metastasize (spread) via arteries, veins, the lymphatic system, and directly. Malignant tumors of the breast, prostate, lung, and kidney can spread into the spine. Spinal tumors can be dangerous when they cause spinal canal compression, which may lead to neurologic dysfunction (e.g. paralysis).

Many patients will present with back pain as the primary symptom. The pain can occur at rest, be worse at night, and may or may not be related to activity. Other symptoms may include sciatica, numbness, paraparesis (slight paralysis), spinal deformity (e.g. scoliosis, kyphosis), and fever.

A coordinated multidisciplinary approach is used to treat spinal tumors. The expertise of a neuroradiologist, pathologist, angiographer, oncologist, and spinal surgeon may be combined during the patient's treatment. The type of tumor, neurologic deficit, spinal deformity (e.g. scoliosis), bony involvement, prior treatment, patient's medical status, pain, and life expectancy are considered prior to treatment.

Aggressive tumors may require surgical resection (partial removal) or excision (complete removal). Others require nonsurgical treatment that may include bracing, radiation, chemotherapy, or embolization. Some tumors require both surgery and nonoperative treatment. Analgesics are given for pain.

If pain is difficult to manage, a pain management specialist may be consulted. Steroids may be prescribed to reduce edema (swelling) that can occur around tumors. Bracing may be used to control pain and provide spinal stability. Radiation and/or chemotherapy may shrink tumors. The dose and frequency of radiotherapy (e.g. radiation) is carefully calculated to destroy cancer cells while preserving healthy cells. Chemotherapy drugs can be administered orally or intravenously.

(1) Pain is unresponsive to nonoperative treatment
(2) Neurologic deficit progresses
(3) A specimen is needed (open biopsy)
(4) The tumor requires debulking (reduce size) to decompress neural elements (e.g. nerves)
(5) Vertebral destruction exists
(6) Spinal stabilization is necessary

(1) If the patient has recently undergone radiation or chemotherapy, their white blood cell count may be too low to fight infection and could compromise healing.
(2) Cancer can affect appetite and eating, which may lead to weight loss and deterioration of general health.
(3) Good pulmonary function is needed to properly oxygenate blood to augment wound healing.

Whether the treatment course is nonoperative or surgical, periodic follow-up visits with the treating physician(s) is essential.