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Spinal Tumours

Spinal tumours represent a very heterogeneous classification. They may be benign or malignant. They may involve the bone of the spinal canal which is the common way that metastatic tumours involve the spine. They maybe located within the spinal canal outside the tube carrying the spinal cord. They maybe within the tube, but outside of the spinal cord itself, pushing on the spinal cord, such as meningiomas or schwannomas or they maybe with the spinal cord substance itself representing classes of gliomas. These tumours may present with pain in the area involved, especially if the bone is involved. If the tumours are within the spinal tube, pain is unusual, but symptoms of loss of function of the spinal cord below the level of the tumour would then become apparent. CT scanning and MRI scanning and, occasionally, CT myelography is utilized to define the tumours.

In the case of metastatic tumours where there is a known primary, especially, radiation therapy maybe the treatment of choice. If the spinal column has been compromised and is unstable, commonly surgery will be utilized to decompress the spinal cord or spinal nerves and will then be followed by some form of fusion of the bones to restore stability. The primary tumours of the spinal cord are often incompletely removed at surgery and follow-up is then carried out in the Brain Tumour Clinic. These tumours are usually astrocytomas, ependymomas or hemangioblastomas. The tumours outside of the cord, but within the dural lining tube, are usually very benign tumours and surgery is usually enough to suffice for their treatment. Long-term follow-up is utilized in these cases. The metastatic tumours going to both bone and spinal canal are the most complex to assess and treat, usually because of the inherent spinal instability and malignant nature. A multidisciplinary approach with the medical oncologists, the radiation oncologists and neurosurgeons is usually utilized.

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