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Lumbar Spinal Cord Tumor


Presentation

  • Discussion A young person presenting with low back and sciatic pain with appropriate neurologic effects leads the physician to think immediately of a herniated lumbar disc syndrome.[healio.com]
  • 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]
  • 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]
  • Schwann cells support the function of nerve cells, and schwannomas can develop anywhere Schwann cells are present. Almost all spinal schwannomas are benign (not cancerous).[weillcornellbrainandspine.org]
Back Pain
  • About three months after the initial consultation, the patient experienced an episode of lower back pain radiating to the left foot brought on by laughter.[healio.com]
  • References: Acute low back pain. EBSCO DynaMed website. Available at: . Updated November 22, 2013. Accessed November 26, 2013. Bratton RL. Assessment and management of acute low back pain. Am Fam Physician. 1999;60:2299-2309. Chronic low back pain.[cancercarewny.com]
  • Therefore, the doctor’s challenge is to determine how to evaluate back pain with the goal of specifically excluding a tumor as the cause of the pain. Luckily, most back pain is not due to a tumor.[pbbsneuro.com]
  • When to see a doctor There are many causes of back pain, and most back pain isn't caused by a tumor.[mayoclinic.org]
  • It's also a good idea to contact your doctor about any back pain that worsens or doesn't go away with time.[columbianeurology.org]
Low Back Pain
  • References: Acute low back pain. EBSCO DynaMed website. Available at: . Updated November 22, 2013. Accessed November 26, 2013. Bratton RL. Assessment and management of acute low back pain. Am Fam Physician. 1999;60:2299-2309. Chronic low back pain.[cancercarewny.com]
  • Case Report History A 32 year old man was referred for consultation after three months of conservative treatment had failed to relieve low back pain with left sciatic pain to the toes. He denied any bowel orbladder control problems.[healio.com]
Spine Pain
  • pain that is worse in the morning Pain that is severe when there is direct manipulation or compression of the affected area of the spine Pain that does not diminish with rest, and pain that may be worse at night than during the day Back pain along with[spine-health.com]
  • Pain mainly when you sit or stand usually means that the tumor is causing weakness or instability in the bones of your spine. Pain primarily at night or in the early morning that gets better as you move is often the first symptom of a tumor.[mskcc.org]
Acute Low Back Pain
  • Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010;(6):CD007612. Hagen KB, Hilde G, et al. Bedrest for acute low back pain and sciatica.[cancercarewny.com]
Muscle Tenderness
  • On initial physical examination, he had low back muscle tenderness without spasm. Straight leg raising on the left side produced left sciatic pain at 40 of elevation. The left Achilles tendon reflex was absent.[healio.com]
Sciatica
  • Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010;(6):CD007612. Hagen KB, Hilde G, et al. Bedrest for acute low back pain and sciatica.[cancercarewny.com]
  • Neurosurgery and Emergency Care Intracranial Hemorrhage Spinal Cord Injury Spine Fractures Traumatic Brain Injury SPINE Cervical, Thoracic, and Lumbar Degenerative Spine Disease Degenerative Disc Disease Foraminal Stenosis Herniated Disc Radiculopathy Sciatica[vaneurosurgeons.com]
Paresthesia
  • Reduced sensory function Cold sensation in the lower limbs Cold, clammy skin Incontinence, both urinary and fecal Paresthesia (burning, prickling, itching, or tingling of the skin) especially on the lower limbs Paralysis Spinal Cancer Causes The cause[cancerwall.com]
Urinary Incontinence
  • Urinary incontinence is often associated with a syrinx when the lesion causes disruption of the sacral pathways. Sexual dysfunction may also occur in association with loss of sphincter control.[neurospinewi.com]
Overflow Incontinence
  • When the tumor causes pressure on the second or third sacral nerve roots, micturition is affected and there is paralysis of bladder contractions, bladder distention, and retention of urine with overflow incontinence.[neurospinewi.com]

Workup

  • Electrodiagnostics: Electrical testing of the nerves and spinal cord may be performed as part of a diagnostic workup.[libertyspinecare.com]
  • Treatment After diagnostic workup, spinal cord edema (swelling) should be managed preoperatively with oral or IV steroids. Edema is most commonly managed with a corticosteroid such as Decadron (dexamethasone).[neurospinewi.com]
  • . • INTRODUCTION • ANATOMY • EPIDEMILOGY • NATURAL HISTORY • CLASSIFICATION • ROUTES OF SPREAD • CLINICAL PESENTATION • DIAGNOSTIC WORKUP • PROGNOSTIC FACTOR • DISEASE SPECIFIC MANAGEMENT • CONCLUSION Dodul Mondal 3.[slideshare.net]

Treatment

  • Treatment is decompression, with specific treatment for the individual tumor. The intradural-extramedullary tumors comprise about 35% of spinal canal tumors. Meningiomas and neurofibromas are most frequently encountered.[healio.com]
  • 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]
  • Simple cosmetic treatment does not prevent neurologic difficulties and may make later, more complete treatment difficult.[neurosurgery.ucla.edu]
  • Treatment is key for spinal tumours, as any damage it causes can be made more severe or indeed, permanent, if treatment is not sought soon enough.[spinalcord.com]
  • Schedule a consultation today to discuss your treatment plan with our surgeons.[vaneurosurgeons.com]

Prognosis

  • – Symptoms, Survival Rate & Prognosis[cancerwall.com]
  • Treatment is total excision with the prognosis dependent on the tumor. The intradural-intramedullary tumor occurs in about 15% of cases. The usual tumor is an ependymoma, astrocytoma, or glioma.[healio.com]
  • Prognosis The prognosis varies depending on the nature of the tumor cells, their aggressiveness and the sensitivity of the tumor to radiation and chemotherapy.[spinehealth.com]
  • Prognosis of Meningioma of the Spinal Cord Benign meningiomas are associated with a very good survival prognosis with approximately 100% 5 year survival.[myvmc.com]
  • . - Metastatic Tumors of the spine: - carcinoma of the breast, kidney, or multiple myeloma may have relatively good long term prognosis; - metastatic carcinoma of the prostate or lung may have poor 1 year survival; - patients w/ combination of spinal[wheelessonline.com]

Etiology

  • Etiology and Pathophysiology: Spinal cord tumors can be primary or metastatic.[neurospinewi.com]
  • Etiology and pathogenesis. There is considerable evidence that some neoplasms are the result of genetic disease. Genetic systemic diseases associated with intradural tumors are neurofibromatosis and von Hippel-Lindau disease.[mauriziopiredda.it]
  • […] associated finding • Majority of intramedullary neoplasms show at least some enhancement • Contrast study essential: Enhancement useful in focal masses, especially hemangioblastoma and mets Contrast helpful in differentiating suspected neoplasms from other etiologies[slideshare.net]

Epidemiology

  • Currently, the Surveillance Epidemiology and the End Results (SEER) Program and the Central Brain Tumor Registry (CBTRUS) group all grades of ependymomas together for reporting purposes.[cern-foundation.org]
  • Tumori primitivi del rachide Maggiori informazioni sulla chirurgia vertebrale Maggiori informazioni sul chirurgo vertebrale Piredda Maurizio Versione in Italiano Epidemiology. Primary spine tumors are relatively rare.[mauriziopiredda.it]
  • Primary spinal cord glioma: a Surveillance, Epidemiology, and end results database study. J Neurooncol2010;98(1):83–92 Dodul Mondal 18.[slideshare.net]
Sex distribution
Age distribution

Pathophysiology

  • Etiology and Pathophysiology: Spinal cord tumors can be primary or metastatic.[neurospinewi.com]

Prevention

  • BACKGROUND: Postoperative cerebrospinal fluid (CSF) leakage is a major clinical problem, and prevention of CSF leakage at the surgical site is an important issue.[ncbi.nlm.nih.gov]
  • 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]
  • Prompt intervention may prevent paralysis .[medical-dictionary.thefreedictionary.com]
  • The main priority is to administer treatment as quickly as possible to prevent progression. The three most commonly used treatments are surgery, radiation, and chemotherapy.[libertyspinecare.com]
  • High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults. Spine J. 2009;9:147-168. 2/17/2009 DynaMed's Systematic Literature Surveillance : Chou R, Fu R, et al.[cancercarewny.com]

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