Spinal tumors can be benign or malignant growths originating in the spine or spreading from other sites. Symptoms include pain, weakness, numbness and paralysis. While the specific cause is often unknown, some genetic conditions increase risk. Magnetic resonance imaging (MRI) is typically used for diagnosis. Treatment depends on the type and severity of the tumor but may include medication, surgery or other procedures.

2. Definition
• A spinal tumor is an abnormal mass of tissue
within or surrounding the spinal
cord and/or spinal column. These cells grow and
multiply uncontrollably, seemingly unchecked by
the mechanisms that control normal cells. Spinal
tumors can be benign (non-cancerous)
or malignant (cancerous). Primary tumors
originate in the spine or spinal cord,
and metastatic or secondary tumors result from
cancer spreading from another site to the spine.

11. Causes and Risk Factors
The cause of the majority of spinal tumors is currently not known. Primary spinal
tumors are associated with a few genetic syndromes. The cause of the majority of
spinal tumors is currently not known. Primary spinal tumors are associated with a
few genetic syndromes.[1][5] Neurofibromas are associated with neurofibromatosis
1 (NF1).[1] Meningiomas and schwannomas are associated with neurofibromatosis
2 (NF2).[1] Intramedullary hemangioblastomas can be seen in patients with von
Hippel-Lindau disease.[5] Spinal cord lymphomas are commonly seen in patients
with suppressed immune systems.[5] The majority of extradural tumors are due to
metastasis, most commonly from breast, prostate, lung, and kidney cancer.

12. Signs and Symptoms
• The symptoms of spinal tumors are often non-
specific, resulting in a delay in diagnosis.
Spinal nerve compression and weakening of
the vertebral structure cause the symptoms.
• Pain is the most common symptom at
presentation.
• muscle weakness, sensory loss, numbness in
hands and legs, and rapid
onset paralysis. Bowel or bladder incontinence
• Back pain is a primary symptom of spinal cord
compression in patients with known
malignancy.

30. Definition
• Spinal disc herniation is an injury to the
cushioning and connective tissue
between vertebrae, usually caused by
excessive strain or trauma to the spine.

31. CAUSES
• Herniation of the contents of the disc into the
spinal canal often occurs when the anterior
side (stomach side) of the disc is compressed
while sitting or bending forward, and the
contents (nucleus pulposus) get pressed
against the tightly stretched and thinned
membrane (anulus fibrosus) on the posterior
side (back side) of the disc.

32. • The majority of spinal disc herniations occur in
the lumbar spine (95% at L4–L5 or L5–
S1).[13] The second most common site is
the cervical region (C5–C6, C6–C7).
The thoracic region accounts for only 1–2% of
cases. Herniations usually occur postero-
laterally, at the points where the anulus
fibrosus is relatively thin and is not reinforced
by the posterior or anterior longitudinal
ligament.

33. Signs and symptoms
• They can range from little or no pain, if the disc
is the only tissue injured, to severe and
unrelenting neck pain or low back pain that
radiates into regions served by nerve roots
which have been irritated or impinged by the
herniated material. Often, herniated discs are
not diagnosed immediately, as patients present
with undefined pains in the thighs, knees, or
feet.

34. • Symptoms may include sensory changes such
as numbness, tingling, paresthesia, and motor
changes such as muscular weakness, paralysis,
and affection of reflexes.

35. Diagnosis
• Physical examination.
Diagnosis of spinal disc herniation is made by a
practitioner on the basis of a patient's history
and symptoms, and by physical examination.
During an evaluation, tests may be performed
to confirm or rule out other possible causes
with similar symptoms – spondylolisthesis,
degeneration, tumors, metastases and space-
occupying lesions, for instance – as well as to
evaluate the efficacy of potential treatment
options.

36. • Projectional radiography (X-ray imaging).
Traditional plain X-rays are limited in their
ability to image soft tissues such as discs,
muscles, and nerves, but they are still used to
confirm or exclude other possibilities such as
tumors, infections, fractures, etc. In spite of
their limitations, X-rays play a relatively
inexpensive role in confirming the suspicion of
the presence of a herniated disc. If a suspicion
is thus strengthened, other methods may be
used to provide final confirmation.

37. • Computed tomography scan (CT or CAT scan) is a
diagnostic image created after a computer reads X-
rays. It can show the shape and size of the spinal canal,
its contents, and the structures around it, including soft
tissues. Still, visual confirmation of a disc herniation
can be difficult with a CT.
• Magnetic resonance imaging (MRI) without contrast is
a diagnostic test that produces three-dimensional
images of body structures using powerful magnets and
computer technology. It can show the spinal cord,
nerve roots, and surrounding areas, as well as
enlargement, degeneration, and tumors. It shows soft
tissues better than CAT scans. An MRI performed with
a high magnetic field strength usually provides the
most conclusive evidence for diagnosis of a disc
herniation. T2-weighted images allow for clear
visualization of protruded disc material in the spinal
canal.

38. • Electromyography and nerve conduction
studies (EMG/NCS) measure the electrical
impulses along nerve roots, peripheral nerves,
and muscle tissue. Tests can indicate if there is
ongoing nerve damage, if the nerves are in a
state of healing from a past injury, or if there
is another site of nerve compression.
EMG/NCS studies are typically used to
pinpoint the sources of nerve
dysfunction distal to the spine.

39. Treatment
• Initial treatment usually consists of nonsteroidal anti-
inflammatory drugs (NSAIDs), but long-term use of
NSAIDs for people with persistent back pain is
complicated by their possible cardiovascular and
gastrointestinal toxicity.
• Lumbar disc herniation:Non-surgical methods of
treatment are usually attempted first. Pain medications
may be prescribed to alleviate acute pain and allow the
patient to begin exercising and stretching. There are a
number of non-surgical methods used in attempts to
relieve the condition. They are
considered indicated, contraindicated, relatively
contraindicated, or inconclusive, depending on the
safety profile of their risk–benefit ratio and on whether
they may or may not help:

40. • Education on proper body mechanics
• Physical therapy to address mechanical
factors, and may include modalities to
temporarily relieve pain
(i.e. traction, electrical stimulation, massage)
• Nonsteroidal anti-inflammatory
drugs (NSAIDs)
• Weight control
• Spinal manipulation

41. Surgery
• Surgery may be useful when a herniated disc is causing
significant pain radiating into the leg, significant leg weakness,
bladder problems, or loss of bowel control.
• Discectomy (the partial removal of a disc that is causing leg
pain) can provide pain relief sooner than non-surgical
treatments.
• Small endoscopic discectomy (called nano-endoscopic
discectomy) is non-invasive and does not cause failed back
syndrome.
• Invasive microdiscectomy with a one-inch skin opening has
not been shown to result in a significantly different outcome
from larger-opening discectomy with respect to pain. It might
however have less risk of infection.
• Failed back syndrome is a significant, potentially disabling,
result that can arise following invasive spine surgery to treat
disc herniation. Smaller spine procedures such as endoscopic
transforaminal lumbar discectomy cannot cause failed back
syndrome, because no bone is removed.