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 typically present in patients in the fourth decade of life and have a male predominance. Osteosarcomas are most common in the lumbosacral segments. Patients often present with pain and a palpable mass. [patient.info]
The present study reports a case of easily misdiagnosed delayed metastatic intraspinal extradural melanoma of the lumbar spine. A 67‑year‑old female patient presented with lower back pain accompanied by progressive intermittent claudication. [spandidos-publications.com]
Contrast enhancement is generally present and is usually heterogeneous. [appliedradiology.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]
Musculoskeletal
-
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]
View/Print Figure Low Back Pain FIGURE 1. Suggested approach to the initial assessment of the patient with acute low back pain. (CT computed tomographic; MRI magnetic resonance imaging) Adapted from Bigos SJ, et al. [aafp.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]
View/Print Figure Low Back Pain FIGURE 1. Suggested approach to the initial assessment of the patient with acute low back pain. (CT computed tomographic; MRI magnetic resonance imaging) Adapted from Bigos SJ, et al. [aafp.org]
-
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]
Suggested approach to the initial assessment of the patient with acute low back pain. (CT computed tomographic; MRI magnetic resonance imaging) Adapted from Bigos SJ, et al. Acute low back problems in adults. Rockville, Md.: U.S. [aafp.org]
-
Neurogenic Claudication
These degenerative changes can be superimposed on a congenitally narrow canal. 18 [ corrected ] Lumbar spinal stenosis may result in neurogenic claudication. In this condition, leg pain is brought on by walking and is relieved by sitting. [aafp.org]
Urogenital
-
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]
Neurologic
-
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]
Neurological examination revealed a positive Laséque's sign, which distinguishes sciatica from disease of the hip joint, weakness of the extensor hallucis longus and decreased ankle reflex in his right lower extremity. [nature.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]
The patient should be asked about paresthesias, numbness or weakness. Muscle weakness, if progressive, must be evaluated urgently. [aafp.org]
-
Decreased Ankle Reflex
Neurological examination revealed a positive Laséque's sign, which distinguishes sciatica from disease of the hip joint, weakness of the extensor hallucis longus and decreased ankle reflex in his right lower extremity. [nature.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]
Treatment for children is usually different than treatment for adults. (See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information about the treatment of adults.) [cancer.gov]
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]
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]
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 of Meningioma of the Spinal Cord Benign meningiomas are associated with a very good survival prognosis with approximately 100% 5 year survival. [myvmc.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]
What is the Prognosis of Spinal Schwannoma? (Outcomes/Resolutions) The prognosis of Spinal Schwannoma (benign tumor) is excellent, if the tumor can be removed without damaging the underlying nerve. [dovemed.com]
Etiology
(Etiology) The exact cause and mechanism of Spinal Schwannoma formation, in a majority of cases, is unknown; they are known to be the result of sporadic mutations. This implies that they do not have a preceding family history of the condition. [dovemed.com]
Etiology and Pathophysiology: Spinal cord tumors can be primary or metastatic. [neurospinewi.com]
[…] 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]
Primary spinal cord glioma: a Surveillance, Epidemiology, and end results database study. J Neurooncol2010;98(1):83–92 Dodul Mondal 18. [slideshare.net]
They provide comprehensive information about the diagnosis, treatment, epidemiology, and prognostic factors of chordoma: Building a global consensus approach to chordoma: a position paper from the medical and patient community Chordoma: current concepts [chordomafoundation.org]
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]