The symptoms depend on the location, type of tumor and the patient's general health. Tumors that have spread to the spine from another site often progress quickly. Primary tumors often progress slowly over weeks to years.
Tumors in the spinal cord usually cause symptoms, sometimes over large portions of the body. Tumors outside the spinal cord may grow for a long time before causing nerve damage.
Symptoms may include:
- Abnormal sensations or loss of sensation, especially in the legs (may be in the knee or ankle, with or without shooting pain down the leg)
- Back pain that gets worse over time, is often in the middle or lower back, is usually severe and not relieved by pain medicine, gets worse when lying down or straining (such as during a cough or sneeze), and may extend to the hips or legs
- Cold sensation of the legs, cool fingers or hands, or coolness of other areas
- Fecal incontinence
- Inability to keep from leaking urine (urinary incontinence)
- Muscle contractions, twitches or spasms (fasciculations)
- Muscle function loss
- Muscle weakness in the legs that causes falls, makes walking difficult and may get worse
Metastatic tumors usually produce pain that does not get better with rest, may be worse at night and is often accompanied by other signs of serious illness (such as weight loss, fever, chills, shakes, nausea or vomiting).
Causes and Risk Factors
There are four common types of spinal tumors that can cause back pain: vertebral column tumors, intradural-extramedullary tumors (in the membranes called meninges that cover the spinal cord), intramedullary tumors (inside the spinal cord) and extradural tumors (between the meninges and bones of the spine). There are also a small number of spinal tumors that occur in the nerves of the spinal cord itself, which most often are ependymomas and other gliomas.
Tumors that start in spinal tissue are called primary spinal tumors. Tumors that spread to the spine from some other place (metastasize) are called secondary spinal tumors. Tumors may spread to the spine from the breast, prostate, lung and other areas.
The cause of primary spinal tumors is unknown. Some primary spinal tumors occur with certain inherited gene mutations.
As a tumor grows, it can affect blood vessels, vertebrae of the spine, the meninges, nerve roots and spinal cord cells. The tumor also may press on the spinal cord or nerve roots, causing damage. With time, the damage may become permanent.