Brain tumors and spinal cord tumors are included in the number of the most dangerous oncologic illnesses. Their surgical treatment is often difficult because of the possibility to damage functional nerve tissue followed by the formation of a stable neurological deficit. Compared to the neoplasms of the brain, tumors of the spinal cord develop 6 times less. Let’s talk about what kinds of cancer occur, why they occur, how they are diagnosed and treated.
Types of spinal cord tumors
Depending on the location they differ between:
- Intramedullary tumors of the spinal cord are located directly in the body of this organ with a lesion of cinerea
- Extramedullary tumors are located outside the spinal cord
Extramedullary tumors can be epidural (outside the hard shell) or subdural (within it). Due to histological classification, spinal cord tumor can be glial or shell. Glial tumors are more malignant neoplasms. There are also secondary tumors which are metastases of cancer of other localization.
Causes of spinal cord tumors
Doctors are not aware yet what are the causes of spinal cord tumors. Some risk factors have been established, but most of them have not been studied yet.
These are main known causes of spinal cord tumors:
- Exposure to radiation
- Heredity (including inherited mutations of some genes)
- Immunodeficiency conditions
There are also several risk factors that can be causes of spinal cord tumors, which has not yet been confirmed definitively. It is assumed that the cancer is caused by vinyl chloride, oil products, aspartame, strong electromagnetic fields, and some viruses. All these factors that can be causes of spinal cord tumors are still being investigated. Unambiguous conclusions about their impact on the likelihood of cancer have not yet been made.
Symptoms of spinal cord tumors
Intramedullary tumor of the spinal cord at the initial stage is characterized by loss of sensitivity of various parts of the body, depending on the level of damage. Sensory violations spread from top to bottom. Motor functions can also suffer. What symptoms of a spinal cord tumor predominate, depends on which horns are damaged - the front or rear (sensitive or motor).
In the next stage, the conduction pathways of the spinal cord (white substance) are squeezed. In this case, symptoms of the spinal cord tumor increase. Functions of the pelvic organs are violated. The neoplasm of intramedullary localization rapidly increases in size.
Extramedullary tumors of the spinal cord symptoms often resemble clinical symptoms of osteochondrosis. The disease is characterized by soreness in the region of the spinous processes of the vertebrae. Doctor can detect a large volumetric formation located in the region of the spine. Pathological vertebral fractures often develop.
There are several ways to determine the tumor of the spinal cord. For this, instrumental diagnostic methods are used. First, the tumor-like formation has to be visualized.
The following methods are used:
- Myelography. This is an x-ray study when a contrast medium is used. It can be ascending or descending. With ascending myelography, a lumbar puncture is performed. Contrast is introduced, and then the person's feet are raised up. A tumor will be where the movement of the contrast medium stops. But more effective is a descending myelography. Contrast is introduced sub-cicliptally (through a large occipital cistern) while patient is sited.
- Isotope myelography is a similar method, but it differs in that radium is introduced into the subarachnoid space, and then the degree of its spread is determined by means of a dosimeter.
- MRI is the most informative method. It allows you to obtain an image of the spinal cord in any sections - both transverse and sagittal (longitudinal).
- Investigation of cerebrospinal fluid. In the analysis of cerebrospinal fluid, there may also be signs of a malignant tumor of the spinal cord, for what the lumbar puncture is done. In CSF, the protein content sharply increases. At a cytological study, atypical cells are found.
Treatment of the spinal cord tumor can be radical only in case of extramedullary neoplasms. They are located outside the spinal cord. Therefore, such tumors are subject to surgical removal. Sometimes it is necessary to remove one root of the spinal cord, but all functions are restored on average in a year. With a benign tumor, the prognosis is favorable. But with malignant neoplasm of intramedullary localization, the treatment of the tumor of the spinal cord cannot be radical. Cancer cannot be removed, as it affects most of the pathways. Decompensating operations are possible with the removal of the vertebral arches and the opening of the dura mater. A biopsy and a histological examination of the neoplasm are performed.
After this, the radio sensitivity of the tumor is determined and irradiation becomes possible. It is better to conduct radiation therapy in well-equipped clinics, since it is risky to treat a tumor of the spinal cord in this way. It is possible to develop radio necrosis, as a result of which the conductivity deteriorates. More qualitative irradiation allows a lesser affect to healthy tissues, which reduces the risks of therapy.
Arrangement of treatment in Germany
Many tumors of the spinal cord can be cured in Germany. In case of malignant neoplasms modern operations and methods of radiation therapy can prolong the life of the patient.
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Author: Dr. Nadezhda Ivanisova