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Cervical Spinal Cord Tumor


Presentation

  • One patient who underwent laminoplasty presented recurrent neurilemmoma, which could be removed easily by virtue of less adhesion and undistorted anatomy.[jkns.or.kr]
  • An uncommon presentation is acute headache due to subarachnoid hemorrhage 8. In children, progressive scoliosis may be seen. Motor regression and frequent falls may be the presenting features in young children 7.[radiopaedia.org]
  • They present as enhancing masses and will not cause a differential problem. All other cord tumors are uncommon. The images are of a patient with neurofibromatosis who has multiple ependymomas. They present as multiple enhancing masses.[radiologyassistant.nl]
  • Most patients with spinal metastatic cancer will present to the physician’s office with either involvement of the spinal cord and nerve endings, or the vertebral column bones.[spinemd.com]
  • Neck or back pain are common presenting symptoms of spinal cord tumors. The pain is often present at night and is worsened with physical activity. The symptoms associated with spinal cord tumors may also vary depending on the level of involvement.[spine.org]
Pain
  • Quality and Outcomes Database (N2QOD) Principal Investigator: Ali Bydon, MD Summary: To date, no nationally collaborative reporting mechanisms utilizing validated quality and outcome measures have assessed 1) to what extent lumbar spinal surgery improves pain[hopkinsmedicine.org]
  • Some common signs of spinal tumors may include: Pain (back and/or neck pain, arm and/or leg pain) Muscle weakness or numbness in the arms or legs Difficulty walking General loss of sensation Difficulty with urination (incontinence) Change in bowel habits[cancercenter.com]
  • Children with a distinct, focused pain in their spine also need to be examined. Typically, a spine tumor causes pain in the spine itself. You can feel pain in your cervical (neck), thoracic (middle of the back), or lumbar spine (lower back).[mountsinai.org]
  • This pain often radiates to other areas of the body and may be worse at night.[spinemd.com]
  • Neck pain; pain that extends toward the shoulder, between the shoulder blades, and even pain in the back of the head. There may also be radicular symptoms with pain, numbness, or weakness extending into the arms or legs.[acsneuro.com]
Disability
  • These result in very significant weakness of limbs with gross physical disability. Bladder and bowel disturbances, ependymomas, astrocytomas are the most common. MRI with contrast is diagnostic.[medtube.net]
  • Outcomes Database (N2QOD) Principal Investigator: Ali Bydon, MD Summary: To date, no nationally collaborative reporting mechanisms utilizing validated quality and outcome measures have assessed 1) to what extent lumbar spinal surgery improves pain, disability[hopkinsmedicine.org]
  • Main content Spinal tumor malignant or not can cause permanent disability. Using advanced microsurgery techniques and radiosurgery, neurosurgeons can safely, partially or completely, remove spinal tumors.[cpmc.org]
  • Spine tumors can be life-threatening and may lead to permanent disability. The Stanford Brain and Spine Tumor Program is a global referral center for the diagnosis and treatment of spinal tumors.[stanfordhealthcare.org]
  • Longitudinal case series of TM reveal that approximately 1/3 of patients recover with little to no sequelae, 1/3 are left with moderate degree of permanent disability, and 1/3 have severe disabilities. Here images of a typical case of TM.[radiologyassistant.nl]
Swelling
  • Cord swelling after surgery is not unusual, which can temporarily cause symptoms to get worse immediately following surgery. Often, medications such as steroids are used to decrease nerve tissue swelling and help to decompress the nerve.[josephmaroon.com]
  • Injury to the spinal cord or the area around the cord can lead to swelling, which can cause compression. Bleeding disorders coupled with chiropractic manipulation can result in large clots compressing the spinal cord.[healthline.com]
  • There is no swelling and no enhancement. It does not look like MS or tumor, so we are thinking ATM - acute transverse myelitis.[radiologyassistant.nl]
  • Computed tomography can determine the location of the tumor on the spinal cord, and also can help to detect swelling, bleeding and other associated conditions.[drugs.com]
  • […] weighted images rim enhancement cord expansion may show restricted diffusion on DWI may have adjacent vertebral or disc abnormalities spinal cord contusion (acute) isointense to hypointense on T1 weighted images, hyperintense on T2 weighted images cord swelling[radiopaedia.org]
Physician
  • Study Title: NA_00023202 Principal Investigator: Chetan Bettagowda, MD Summary: Physicians at the Johns Hopkins Hospital are participating in a FDA approved clinical trial that is testing a novel therapy for patients with recurrent chordoma, a rare spine[hopkinsmedicine.org]
  • Research – Our physicians work with academic medicine researchers to develop new techniques, enhancing orthopedic care. Collaboration – Our team of experts works together to develop an individualized treatment plan for you.[houstonmethodist.org]
  • Her primary care physician thought she had arthritis, but she saw a chiropractor who noted brisk reflexes on her neurologic examination.[spinemd.com]
  • Please consult your physician for a complete list of indications, warnings, precautions, adverse events, clinical results and other important medical information.[acsneuro.com]
  • The missed or delayed diagnosis may occur because a physician: Does not take the time to learn of the patient’s symptoms Fails to refer a patient to a neurologist or neurosurgeon Does not review a patient’s full medical history Fails to conduct a physical[powers-santola.com]
Surgical Procedure
  • Treatment includes correction of the cause and surgical procedures to drain the syrinx or otherwise open CSF flow. Syrinxes usually result from lesions that partially obstruct CSF flow.[merckmanuals.com]
  • His focus is not just on the single event of a surgical procedure but rather on total spine care and the constant pursuit of better outcomes for patients.[profiles.utsouthwestern.edu]
Neck Pain
  • At our office visit she complained of an insidious onset of neck pain, which had recently become quite severe. There was no obvious injury to cause progressive neck pain. Any posture other than lying flat in bed caused her significant discomfort.[spinemd.com]
  • What Cervical Spine Pain Could Mean Neck pain can be debilitating and there is a wide range of possible causes.[centerforneuroandspine.com]
  • Some common signs of spinal tumors may include: Pain (back and/or neck pain, arm and/or leg pain) Muscle weakness or numbness in the arms or legs Difficulty walking General loss of sensation Difficulty with urination (incontinence) Change in bowel habits[cancercenter.com]
  • Neck pain; pain that extends toward the shoulder, between the shoulder blades, and even pain in the back of the head. There may also be radicular symptoms with pain, numbness, or weakness extending into the arms or legs.[acsneuro.com]
  • Signs and Symptoms Back or neck pain is usually the first symptom of a spinal cord tumor. Some people experience sharp pain only when they walk. This can occur when a soft tumor replaces solid bone in the spine, which can make the spine unstable.[nyulangone.org]
Myelopathy
  • Another case with myelopathy and dilated veins as a result of an AVF. Another patient with myelopathy and dilated vessels surrounding the cord. Notice the hypointense areas on the T2WI which represents hemorrhage.[radiologyassistant.nl]
  • Differential diagnosis includes degenerative cervical spondylotic myelopathy, spinal epidural abscess/hematoma and a group of non- compressive myelopathies including acute tranverse myelopathy, examples include: Vascular: Acute spinal cord infarction[clinicaladvisor.com]
  • Your doctor may order a CT scan, MRI, PET scan (positron emission tomography), or myelogram if symptoms of spinal cord compression (ie, myelopathy ) are present. If the imaging studies are positive for a tumor, a biopsy may be performed.[spineuniverse.com]
  • Kawakami and Mair first reported of a 68 year-old man on anticoagulation therapy for pulmonary embolism who was evaluated for cervical myelopathy.[omicsonline.org]
  • Lhermitte's sign is most prevalent in patients with multiple sclerosis, cervical spondylotic myelopathy, cisplatin neurotoxicity, cervical radiation injury, and neck trauma.[link.springer.com]
Paresthesia
  • Initial symptoms included occipital pain, glove-type numbness, and paresthesia of the upper extremities. In all three cases, myelopathic signs preceded radicular signs.[journals.lww.com]
  • Clinically, they sought medical care because of progressive paresthesias or urinary incontinence caused by a nodular, fairly circumscribed intraspinal tumor of the cervical and thoracic spinal cord, respectively.[sogacot.org]
  • In the recovery room immediately after surgery, paresthesias and hyperesthesia may be troublesome. E.[clinicaladvisor.com]
  • .: Ectopic sensory discharges and paresthesiae in patients with disorders of peripheral nerves, dorsal roots and dorsal columns. Pain 20: 231–245, 1984 Google Scholar 22. Brieg A: Adverse Mechanical Tension in the Central Nervous System.[link.springer.com]
Numbness of the Hand
  • It may also result in numbness in the hands and arms. Many cases of cervical degenerative disc disease can be successfully treated with conservative care.[centerforneuroandspine.com]
Hyperreflexia
  • Below that level, Upper Motor Neuron (UMN) findings are those of spasticity, hyperreflexia with upgoing Plantar reflex also called Babinski’s sign With Extradural lesion (i.e. spinal metastasis), early symptoms are motor and sensory in an asymmetric onset[clinicaladvisor.com]
Clonus
  • Coming down the stairs or stepping off a curb will reveal ankle clonus felt as “vibrations” by patient.[clinicaladvisor.com]
Urinary Incontinence
  • Clinically, they sought medical care because of progressive paresthesias or urinary incontinence caused by a nodular, fairly circumscribed intraspinal tumor of the cervical and thoracic spinal cord, respectively.[sogacot.org]

Workup

  • He did not pursue further workup at the time as he was asymptomatic except for intermittent back pain.[omicsonline.org]

Treatment

  • Treatment is microsurgical excision, followed by radiation depending on nature of the tumor.[medtube.net]
  • The Complex Spine Study Group database is designed to develop a better understanding of spinal disease and deformities, and how they have responded to various forms of treatment and interventions.[hopkinsmedicine.org]
  • Your radiotherapy team use this scan to plan your treatment. At the beginning of each treatment session, you lie in the same position but under the radiotherapy machine. The treatment itself only takes a few minutes.[macmillan.org.uk]
  • Radiation Therapy Your doctor may recommend radiation therapy as a standalone treatment or as additional treatment to destroy any tumor cells that may remain after surgery.[stanfordhealthcare.org]
  • Treatment at a major brain and spine center will give patients the widest range of expert treatment options, along with access to clinical trials for spine tumors.[weillcornellbrainandspine.org]

Prognosis

  • Unfortunately, even if the most aggressive treatment is attempted, the prognosis is usually unfavorable. There are few promising therapies being developed for GBM treatment.[bnasurg.com]
  • Prognosis and Patient Counseling. With epidural spinal metastases prognosis is generally poor. For example, median survival after radiotherapy for lung primary is 1.5 months while with breast cancer it is 9 months.[clinicaladvisor.com]
  • The treatment and prognosis for a spine tumor vary based on whether it is primary or metastatic, benign or malignant, and other factors.[weillcornellbrainandspine.org]
  • Prognosis The prognosis will depend upon the location of the tumor on the spinal cord, the type of tumor and the size of the tumor at the time of diagnosis.[drugs.com]
  • The approach was chosen based on tumor location, prognosis and the need for fixation. For 6 patients an anterior approach was used, for 31 pacients we used a posterior approach and 7 patients required a combined anterior and posterior approach.[degruyter.com]

Etiology

  • Review of etiology, diagnosis, and multi-disciplinary approach to treatment. Cancer Practice 3: 207–218, 1995. Google Scholar 18. Epstein FJ, Farmer JP, Freed D: Adult intramedullary spinal cord ependymomas: The result of surgery in 38 patients.[link.springer.com]

Prevention

  • Prevention Although spinal cord tumors cannot be prevented, some forms of cancer that spread to the spinal cord can be prevented or cured before they can spread to the spine.[drugs.com]
  • You can prevent some tumors by maintaining a healthy lifestyle. We do not know a lot about preventing spine tumors. Early detection of a spine tumor is the best known step to successful treatment.[mountsinai.org]
  • Tests may include: MRI scan of the spinal canal and spinal cord with and without contrast material Angiography —uses contrast material to see blood vessels Plain x-rays and CT scan of the spinal canal Prevention There are no current guidelines to prevent[seattleneurosciences.com]
  • It may not be possible to prevent spinal cord compression in all cases because there are so many possible causes.[healthline.com]
  • To prevent permanent harm, an emergency surgery may be required.[powers-santola.com]

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