There are three common types of spinal tumors that can cause back pain: vertebral column tumors, intradural-extramedullary tumors, and intramedullary tumors.
1. Vertebral Column Tumors
Primary tumors: These tumors occur in the vertebral column, and grow either from the bone or disc elements of the spine. They typically occur in younger adults. Osteogenic sarcoma (osteosarcoma) is the most common malignant bone tumor. Most primary spinal tumors are quite rare and usually grow slowly.
Metastatic tumors: Most often, spinal tumors metastasize (spread) from cancer in another area of the body (see Figure 1). These tumors usually produce pain that does not get better with rest, may be worse at night, and is often accompanied by other signs of serious illness (such as weight loss, fever/chills/shakes, nausea or vomiting).
- In women, spinal tumors most frequently spread from cancer that originates in the breast or lung.
- In men, spinal tumors most frequently spread from cancer that originates in the prostate or lung.
2. Intradural-Extramedullary Tumors
Intradural-Extramedullary (inside the dura) tumors grow within the spinal canal (under the membrane that covers the spinal cord) but outside of the nerves. Usually these tumors are benign and slow growing. However, they can cause symptoms of pain and weakness.
Most of these spinal tumors are:
- Meningiomas that occur in the membranes surrounding the spinal cord and are usually benign but may be malignant. These tumors are more common in middle age and elderly women.
- Nerve sheath tumors (schwannomas and neurofibromas) that arise from the nerve roots that come off the spinal cord. Again, this type of tumor is usually benign and slow growing, and it may be years before any neurological problems occur.
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3. Intramedullary Tumors
Intramedullary tumors grow from inside the spinal cord or inside the individual nerves and often arise from the cells that provide physical support and insulation for the nervous system (glial cells). These tumors occur most often in the cervical spine (neck). They tend to be benign, but surgery to remove the tumor may be difficult.
The two most common types of intramedullary tumors are astrocytomas and ependymomas.