Types of Spinal Tumors and How They’re Treated

Learning that a spinal tumor may be causing back pain or neurological symptoms can be frightening. Questions about whether the tumor is cancerous, how it will affect the spinal cord, and what treatment may involve are often the first concerns patients have after receiving a diagnosis.

The good news is that spinal tumors are not all the same. Some grow slowly and never spread beyond the spine, while others require more aggressive treatment. Understanding the different types of spinal tumors can help patients and their families better understand a diagnosis and why treatment recommendations vary from person to person.

In this guide, we’ll explain the different types of spinal tumors, how they’re classified, and the treatment options available. We’ll also discuss when it’s time to seek an evaluation and what patients can expect when receiving specialized spine care.

Understanding Where Spinal Tumors Develop

The brain and spinal cord make up the central nervous system, but spinal tumors can develop in several different structures within the spine. A spinal tumor is an abnormal growth that forms inside the spinal cord, within the tissues surrounding it, or in the vertebrae that support the spine. These different locations help physicians classify spinal tumors and determine the most appropriate treatment approach.

Unlike common spine conditions such as arthritis, spinal stenosis, or degenerative disc disease, spinal tumors involve abnormal tissue growth rather than wear and tear affecting the bones, joints, or discs. Because tumors may involve the spinal cord or nearby nerves, they often require a different diagnostic process and treatment strategy than more common causes of back or neck pain.

How Spinal Tumors Are Classified

The National Cancer Institute classifies spinal tumors in several ways, helping physicians describe where a tumor began, how it behaves, and where it develops within the spine.

The first distinction is where the tumor originated:

• Primary spinal tumors begin within the spine or the tissues surrounding the spinal cord and are relatively uncommon.
• Secondary (metastatic) spinal tumors begin elsewhere in the body before spreading to the spine and account for most spinal tumors diagnosed in adults.

Tumors are also classified as benign tumors or malignant spinal tumors. Benign tumors do not spread to distant organs, although they can still cause significant symptoms if they place pressure on the spinal cord or nearby nerves. Malignant tumors can invade surrounding tissue or spread elsewhere in the body and usually require more extensive treatment.

Primary spinal tumors are further grouped according to where they develop. The three main categories are intramedullary tumors, intradural extramedullary tumors, and vertebral column tumors. Each category includes several different tumor types and may contain both benign and malignant tumors.

Intramedullary Tumors

Intramedullary tumors develop inside the spinal cord itself. Because they develop within the spinal cord, even relatively small tumors can disrupt the nerve signals traveling between the brain and the rest of the body.

The two most common intramedullary tumors are ependymomas and astrocytomas. Ependymomas are seen most often in adults and usually grow slowly, while astrocytomas occur more frequently in children and younger adults and vary in aggressiveness.

Intradural Extramedullary Tumors

Intradural extramedullary tumors develop inside the protective covering surrounding the spinal cord but outside the spinal cord itself. As they enlarge, they can place pressure on the spinal cord or nearby nerves.

Common tumor types in this category include meningiomas, schwannomas, and neurofibromas. Schwannomas and neurofibromas are nerve sheath tumors that are commonly benign. Myxopapillary ependymomas typically occur near the conus medullaris or cauda equina and may cause lower back pain, leg weakness, numbness, or changes in bowel or bladder function.

Vertebral Column Tumors

Vertebral column tumors develop within the vertebrae, the bones that support and protect the spinal cord. Some vertebral column tumors begin in the bone itself, while others develop after cancer spreads to the spine from another part of the body. Depending on the tumor, these growths may weaken the vertebrae, increase the risk of fractures, or place pressure on nearby nerves.

Metastatic Spinal Tumors

Metastatic spinal tumors occur when cancer spreads from another part of the body to the spine. They are far more common than primary spinal tumors and typically originate from breast, lung, prostate, kidney, or thyroid cancers, as well as multiple myeloma.

Because metastatic tumors are part of a broader cancer diagnosis, treatment typically combines surgery with radiation therapy and systemic treatments such as chemotherapy, immunotherapy, or targeted therapy.

Signs and Symptoms of a Spinal Tumor

Symptoms vary depending on the type of tumor and the nerves or structures involved. Some develop gradually over months or years, while others progress much more quickly.

Common symptoms include:

• Persistent neck or back pain
• Pain that worsens at night
• Weakness in the arms or legs
• Numbness or tingling
• Difficulty walking or maintaining balance
• Loss of coordination
• Changes in bowel or bladder function

Many of these symptoms overlap with common spine conditions such as degenerative disc disease and herniated discs. However, tumor-related pain generally becomes progressively worse and may be accompanied by worsening neurological symptoms.

Diagnosing Spinal Tumors

Diagnosing a spinal tumor begins with a review of symptoms, a neurological examination, and advanced imaging.

MRI of the spine with and without contrast is typically the preferred imaging study because it provides detailed views of the spinal cord, nerves, and surrounding soft tissues. CT scans provide additional information about the vertebrae, while CT myelography may be used if MRI cannot be performed.

When imaging cannot definitively identify the tumor type, a biopsy may be recommended. If metastatic disease is suspected, additional staging studies help determine where the cancer originated and whether it has spread elsewhere.

Choosing the Right Treatment for a Spinal Tumor

After a spinal tumor has been identified, the next step is determining the most appropriate treatment plan. Some tumors can be monitored with periodic imaging, while others require surgery, radiation therapy, medication, or a combination of treatments. The decision is based on imaging findings, neurological symptoms, the type and behavior of the tumor, and the patient’s overall health.

For many patients, non-surgical treatments such as radiation therapy, chemotherapy, immunotherapy, or targeted therapy play an important role, particularly for metastatic disease and certain malignant spinal tumors. When surgery is recommended, the objectives are to remove as much of the tumor as safely possible, relieve pressure on the spinal cord or nearby nerves, stabilize the spine if it has been weakened, and, in some cases, obtain tissue for biopsy or prepare the area for additional cancer treatments.

When surgery is part of the treatment plan, every patient at Branko PRPA M.D. Spine Surgery undergoes a comprehensive evaluation to determine the most appropriate surgical approach. Dr. Prpa has experience treating complex spinal tumors and other advanced spine conditions, using minimally invasive techniques whenever appropriate while tailoring each treatment plan to the patient’s diagnosis and long-term goals.

Because spinal tumors often require care from multiple specialists, treatment is coordinated with medical oncologists, radiation oncologists, pain management specialists, rehabilitation providers, and other healthcare professionals to support patients throughout every stage of treatment.

Recovery and Ongoing Care

The recovery process depends on the treatment performed and the patient’s condition before treatment began. Some benign tumors can be completely removed, while others are monitored with periodic MRI scans to watch for changes.

Patients treated for malignant spinal tumors or metastatic disease continue working with both their spine surgeon and oncology team after treatment. Follow-up appointments and surveillance imaging help monitor for recurrence, evaluate healing, and determine whether additional treatment is needed. Continued follow-up helps the care team identify changes early and adjust treatment as needed.

Specialized Spine Tumor Care at Branko PRPA M.D. Spine Surgery

Spinal tumors require specialized evaluation, as early diagnosis and treatment can make a meaningful difference in long-term outcomes. At Branko PRPA M.D. Spine Surgery, we evaluate and treat complex spinal tumors and other advanced spine conditions for patients throughout the Milwaukee area.

Our team develops personalized treatment plans based on each patient’s diagnosis, symptoms, and goals. We carefully evaluate every case, discuss both surgical and non-surgical options when appropriate, and collaborate with other specialists whenever multidisciplinary care is needed. Our focus is on helping patients understand their diagnosis and recommending the treatment approach that best supports their recovery and return to daily activities.

If you’ve been diagnosed with a spinal tumor or are experiencing symptoms that call for further evaluation, we encourage you to schedule a consultation today.