Metastatic Spine Tumors

A spine tumor is an abnormal growth of tissue found in and/or around the spinal column and/or spinal cord.

A spinal tumor can be classified as primary or secondary:

    Primary tumors. Tumors that originate in the spinal tissue are called primary tumors. They can be cancerous or noncancerous. This type of spinal tumor is rare.1

    Secondary tumors. Tumors that spread to the spine from cancer that has started elsewhere in the body are called secondary tumors. This type of tumor is cancerous. It is by far the more common type of spinal tumor. More than 90% of spinal tumors are metastases2. These cancerous tumors may also be referred to as metastatic tumors, metastases, or malignant tumors.

Tumors can grow within the spinal cord, within the dura (protective covering around the spinal cord), or in the vertebral structures; however, spinal cord tumors and tumors within the dura (intradural) tumors are rare.

Article continues below

Extradural, Metastatic Spinal Tumors

More than 95% of all metastatic spinal tumors are found outside the dura (extradural) and within the vertebral body, and in more than half of the cases they are found on multiple levels of the spine.3

This article focuses on this type of spine tumor, referred to as extradural, metastatic spinal tumors.

Metastatic Spinal Tumors of the Bone

It is common for cancer cells to metastasize, or spread, to bones. Most commonly, cancer cells spread to the lung, the liver, and the bones, respectively, and most bone metastases occur in the spine.4-7

The most common way for cancer cells to reach the spine is via the blood stream, after which they enter the bone marrow and begin to multiply.1,6 The most common cancers that metastasize to the spine are breast, lung, and prostate, respectively.1

Tumors within the bone of the spine can make the bone weak enough to eventually fracture. A fracture can be extremely painful and can seriously affect the patient’s quality of life. Growths can compress nerve endings in and around the spine, causing pain and weakness of the arms or legs. In extreme cases paralysis may occur.

Where Spinal Tumors Occur

Spinal tumors can occur anywhere along the spine, but most occur in the thoracic (mid-to-upper back) region:

  • 70% or spine tumors occur in the thoracic region
  • 20% in the lumbar (lower back) region
  • 10% in the cervical (neck) region3

Approximately 80% of patients with systemic cancer will have spinal metastasis; 36% of these patients are asymptomatic,1 meaning they have no symptoms.

When to See a Doctor

Anyone with a cancer or a history of cancer should call the physician if back pain occurs suddenly and/or if existing back pain suddenly becomes much worse.

Cancer patients who develop new symptoms, especially symptoms that involve a neurological component (for example, loss of bowel or bladder control, loss of muscle function or weakness), or radiating pain (that travels into the arm or leg), should seek immediate medical attention.


  1. McLain, Robert F. (2010) Cancer in the Spine: Comprehensive Care. Totowa, NJ: Humana Press.
  2. Simmons ED and Zheng Y. Vertebral tumors: surgical versus nonsurgical treatment. Clinical Orthopeadics and Related Research. 2006;443:223-247.
  3. Constans JP et al. Spinal metastases with neurological manifestations: review of 600 cases. Journal of Neurosurgery. 1983;59:111-118.
  4. Society of Interventional Radiology. Nonsurgical treatments for metastatic cancer in bones. 2013. Accessed at October 17, 2013.
  5. Lee, Chong-Suh and Jung, Chul-Hee. Metastatic Spinal Tumor. Asian Spine Journal. 2012;6(1):71-87.
  6. Laufer I et al. Surgical Management of Metastatic Spinal Tumors. Cancer Control 2012;19(2):122-128.
  7. Muir, Cameron J. Management of Tumors. Journal of the Spinal Research Foundation. 2011; 6(2):25-29.
Written by David DeWitt, MD