Spinal cord neoplasm can be either a primary central nervous system tumor (glial or nonglial) or secondary to metastases. Clinical features depend on the location of the tumor with regards to the level of the spinal cord, but some of the most common symptoms are localized pain, weakness, isolated sensory or motor dysfunction, as well as inadequate sphincter control. Magnetic resonance imaging (MRI) must be performed in order to make the diagnosis.
Neoplastic diseases of the spinal cord are broadly categorized into two main groups - primary and secondary  . Primary tumors of the spinal cord comprise approximately 2-4% of all central nervous system (CNS) malignancies , and are further divided into intradural intramedullary (where glial tumors, such as ependymomas, hemangioblastomas, and astrocytomas are the main subtypes) and intradural extramedullary (tumors of nonglial origin)   . Conversely, metastatic tumors and lymphomas in the epidural space are the main secondary tumors of the spinal cord  . The clinical presentation somewhat varies on the location of the tumor, but the principal features are progressively worsening localized pain (usually in the neck or back ) that may further spread to the lower extremity (radicular pain)  . The pain is described as constant and is most severe when lying on the side (recumbent position) . In addition, patients frequently report weakness, spasticity, and poor motor control if a nerve root is damaged by the tumor, and both sensory input and sphincter control might also be affected  . Neurological deficits (either sensory, motor or both) caused by a spinal cord neoplasm will frequently present in a bilateral fashion while sparing the head and the face . Some authors describe hydrocephalus as a rare, but significant complication of spinal cord neoplasms, affecting 1-8% of patients   . Unfortunately, the diagnosis of spinal cord neoplasms is frequently delayed (hemangioblastoma is confirmed after a mean period of 3 years), which may profoundly reduce the efficacy of treatment   .
What others are saying Regular chiropractic care - Increasingly, the public is becoming more aware of the benefit of chiropractic care for neck pain. AxizPhysio is registered Sports Injury and Rehab Clinic in Mississauga. [pinterest.co.uk]
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]
Symptoms Neck pain is the most common presenting symptom of patients with a cervical spine tumor. Patients often have unrelenting pain, as well as night pain, that is not relieved by rest or traditional measures. [uscspine.com]
[…] changes or confusion Parietal lobe problems with reading or writing loss of feeling in part of the body difficulty with spatial awareness, e.g. telling left from right, locating objects Occipital lobe loss of all or some vision Spinal cord back and neck [cancervic.org.au]
Other spinal cord problems include Tumors Infections such as meningitis and polio Inflammatory diseases Autoimmune diseases Degenerative diseases such as amyotrophic lateral sclerosis and spinal muscular atrophy Symptoms vary but might include pain, numbness [icdlist.com]
They can result in painful scoliosis, muscular atrophy, radicular pain and gait disturbances secondary to pain and splinting. [patient.info]
As spinal cord compromise advances, hyperreflexia and Babinski reflexes are typically present. Lax rectal sphincter tone is a late sign of spinal cord dysfunction. [emedicine.medscape.com]
Neurologic Exam (Motor Exam) Symmetric motor weakness In Epidural Spinal Cord Compression, motor deficits are more common than sensory Pain on Vertebra l body compression Early changes Flaccidity Hyporeflexia Later changes Cauda Equina Syndrome Spasticity Hyperreflexia [fpnotebook.com]
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]
Signs: Neurologic Exam (Motor Exam) Symmetric motor weakness In Epidural Spinal Cord Compression, motor deficits are more common than sensory Pain on Vertebra l body compression Early changes Flaccidity Hyporeflexia Later changes Cauda Equina Syndrome [fpnotebook.com]
The role of an adequate clinical workup is pivotal in making a presumptive diagnosis of an ongoing process in the spinal cord. Physicians must perform a full physical examination, with an emphasis on the neurological exam with sensory and motor testing, and obtain a complete patient history regarding the course, progression, and duration of symptoms. Imaging studies, however, are vital for recognizing lesions of the spinal cord and determining their exact location   . Magnetic resonance imaging (MRI) is the gold standard, particularly for intramedullary neoplasms, and many studies have emphasized its high rate of success in identifying a spinal cord tumor . Some tumors exhibit specific features on MRI - ependymomas and astrocytomas will be either hypo or isointense on T1-weighed imaged and hyperintense on T2-weighed images, while both tumors are enhanced by the use of contrast . However, MRI might not be always able to differentiate between the exact subtypes of spinal cord neoplasms based on imaging criteria, as certain studies showed a 70% success with histological findings from the tumors . For this reason, a definite diagnosis can only be made after obtaining a sample of the tumor either by performing a biopsy or after surgical resection   . Subsequent histopathological examination and immunohistochemistry testing will be able to provide the answer to the etiology of the tumor .
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