The document discusses spinal tumors, classifying them into intramedullary and extramedullary types, with emphasis on benign tumors that compress the spinal cord. It outlines symptoms associated with spinal tumors, including various syndromes, and details treatment options such as surgery and physiotherapy for recovery and management of functional mobility. Prognosis largely depends on the rapidity of treatment and the extent of damage caused by the tumor.

1. SPINAL TUMOR
DR. DARSHAN PARMAR (MPT-NEURO)
GOVT. PHYSIOTHERAPY COLLEGE, JAMNAGAR
GUIDED BY: DR. AKTA MA’AM

2. DEFINITION
Spinal tumor is a growth of tissue that develops within the spinal
canal or within the bones of spine.
Tumors or neoplasm or space occupying lesions are classified
broadly into intramedullary and extramedullary tumors.

3. Majority of intraspinal tumors are benign & produce effects by compression of
spinal cord rather than by invasion.
Thus, a proportion of intraspinal tumors are amenable to surgical removal
Intramedullary tumors are those present within the substance of
the spinal cord.

4. Extramedullary tumors are those present outside the substance of
the spinal cord. They can be further divided into intradural and
extradural.
The intradural ones are meningioma, ones that arise from the
nerve roots and the extradural ones arises from epidural substances
and vertebral bodies.

6. CLASSIFICATION OF TUMORS
EXTRADURAL INTRADURAL INTRAMEDULLARY
IN INFANTS
Neuroblastoma Meningioma Ependymoma
Ganglioneuroma Neurofibroma
Sarcoma Angioma
IN ADULTS
Ganglioneuroma Meningioma Glioma
Sarcoma Neurofibroma Ependymoma
Chondroma

8. INTRAMEDULLARY EXTRAMEDULLARY

9. SYMPTOMS
Tumors of the spinal cord can give rise to any one of the following
symptoms:
• Sensorimotor spinal tract syndrome
• Radicular spinal cord syndrome
• Intramedullary syringomyelia syndrome

10. SENSORIMOTOR SPINAL TRACT SYNDROME
• Starts with Pain and tenderness at affected spinus process
Sensory Signs and Symptoms :
•Spinal tracts affects first leading to impairment in sensation and dysesthesia
• If the Spinothalamic tract is totally compressed then their will be loss of pain
and temperature sensation.
Motor Signs and Symptoms :
• UMN type as their will be compression in corticospinal tract.
•Level of severity depends on amount of compression.

11. RADICULAR SPINAL CORD SYNDROME
• Starts with pain and usually it is radiating type from the affected spine  Intensified
by coughing, sneezing, prolonged recumbency.
• Tingling, Numbness and Paraesthesia
• Areflexia and LMN type of muscular palsy
• Along with the Radiating signs and symptoms, a person may have others symptoms
like spastic paraparesis, loss of pain and temperature sensation, loss of sensation by
posterior column and even bladder-bowel disturbances.

12. INTRAMEDULLARY SYNRIGOMYELIA SYNDROME
• Signs and symptoms are similar to syringomyelia
• Pain  Anterior horn cell gets involved  Involvement of Corticospinal fibers
and other sensory tracts.
• Tenderness on spine detects pain of spinal tumor (aggravated by coughing,
sneezing)
• Associated symptoms are tingling, numbness, paraesthesia or loss of sensation
on particular dermatome.
• Altered DTR

13. INVESTIGATION
• CT scan
• MRI
• Myelogram
• CSF examination

14. PROGNOSIS
Recovery generally depends on how quickly treatment begins and
how much damage was done.
Removal of meningiomas, neurofibromas, and some other primary
spinal cord tumors may be curative.

15. MANAGEMENT
• If symptoms suggest that tumor is compressing spinal cord,
corticosteroids are immediately given in high doses to reduce
swelling
• Surgical intervention  Prognosis is mostly good
• Extradural tumor can be excised
• Intramedullary tumor requires Decompression like laminectomy
followed by radiation.

16. PHYSIOTHERAPY
• Functional Mobility
• Pain management
• Bracing
• Improve Strength and Flexibility
• Bowel/Bladder management

17. FUNCTIONAL MOBILITY
• Patient and caregiver education
• Positioning  for skin and joint integrity
• Bed mobility
• Functional Transfer (Bed to wheelchair, wheelchair to bed,
wheelchair to toilet-seat, wheelchair to chair/stool etc..)
• Gait Training

18. PAIN MANAGEMENT
• Postural bracing
• Hot packs, Cold packs
• TENS

19. BRACING
• Indication :
• Postural correction
• Proprioceptive awareness
• Stabilization of fractures
• Cervical collars (Soft cervical collar, Hard cervical collar)
• TLSO
• AFO
• Abdominal binder
• Compression stockings

20. IMPROVE BALANCE
• Strengthen Lower limb and core muscle  Improve Sitting Balance
 Improve sit to stand  Improve standing balance  Improve
dynamic balance.

21. IMPROVE STRENGTH AND FLEXIBILITY
• Passive ROM  Active assisted ROM  Active ROM  Resisted
Exercise (weight, TheraBand, TheraTubes etc..)
• Stretching of tight muscle to improve flexibility.

22. BOWEL/BLADDER MANAGEMENT
• Pelvic floor exercise
• Kegels exercise
• Pillow squeezing
• Bridging

23. THANK YOU…..