Thomas Jefferson UniversitySidney Kimmel Medical College

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Symptoms & Diagnostic Techniques

Symptoms

A growing tumor will press on the spinal cord, causing problems comparable to a pinched nerve.  Even if a tumor is benign, it can still interfere with the function of the spine.  Spinal cord compression can cause motor weakness, exaggerated reflexes, and pain. 

For any spinal condition, including tumors, the most common complaint is pain.  Identification of a spinal tumor may be delayed as inflammation, fracture, and other possible causes of the pain are considered. 

The pain may be localized (stiff neck or back) or diffuse and burning.  It may show up when the patient is moving or when the patient is reclining.  Pain may be worse at night or just upon awakening, due to changes in blood flow during the night. 

Weakness is the next most common complaint.  There may be clumsiness or a sensory loss that makes the patient feel disconnected from a limb. 

The above assumes that the patient has a "primary" tumor, one that did not travel (metastasize) from another location in the body.  However, such "secondary" tumors may not have symptoms at all.  While 90% of prostate cancers and 75% of breast cancers are associated with secondary spinal tumors, only 10% of patient with prostate cancer and 22% of those with breast cancer reported symptoms. 

Diagnostic Techniques

MRI Imaging

Magnetic resonance imaging (MRI) provides a detailed assessment of intrinsic spinal pathology.  It can detect spinal compression from tumor or from destruction of the vertebrae.  As a rule of thumb, tumors appear dark on "T1-weighted" MRI images which produce anatomic images, and bright on "T2-weighted" images which highlight pathological structures. 

MRI (T1-weighted)T1-weighted image
MRI (T2-weighted)T2-weighted image

X-Ray + myelography

A dye that shows up on X-rays is injected into the cerebrospinal fluid that circulates in the spinal cord.  An X-Ray will then reveal where the dye was blocked from flowing.  The block could be caused by a tumor, scar tissue, or a bony spur.