While it may be relieving to receive a diagnosis of a benign spinal tumor, this type of tumor may still require treatment. Knowing what to expect and what your options are will help put your mind even more at ease as you move through your recovery.
Benign tumors are tumors that are non-cancerous. However, they can still cause issues such as nerve compression, spinal deformation or compromised bone strength. The advantage to dealing with benign tumors is that, unlike their malignant counterparts, they do not metastasize (spread) to other parts of the body.
Malignant tumors are cancerous tumors. Malignancies can metastasize, causing the cancer tissue to invade other parts of the body. Occasionally, malignant spinal tumors are due to cancerous cells traveling to the spine from other parts of the body.
Types of benign spinal tumors and their causes
There are a few types of benign spinal tumors that can occur. They include meningiomas, nerve sheath tumors (such as schwannomas and neurofibroma) and primary bone tumors (such as osteoid osteomas and osteoblastomas).
Meningiomas occur on the membranes that surround the brain and spinal cord. These membranes are called the meninges.
The cause of meningiomas is still not clear. It’s been surmised that genetics, female hormones and radiation therapy may play a role in their development.
Nerve Sheath Tumors
Nerve sheath tumors include both schwannomas and neurofibroma.
Schwannomas grow in the nerve sheath (the fibrous tissue that covers the nerves). These typically benign tumors arise from cells known as Schwann cells, hence the name.
These nerve sheath tumors can be idiopathic (having no known cause), or they may develop due to a hereditary issue know as Neurofibromatosis type 2 (NF2). It’s also speculated that exposure to radiation may lead to the development of these tumors.
Primary Bone Tumors
Primary bone tumors include osteoid osteomas and osteoblastomas.
Osteoid osteomas are small, benign bone tumors. They stem from osteoblasts (the cells that produce bone matrix tissue) and, while they most commonly occur in long bones such as the femur or tibia, they can also grow in the vertebrae. While the reason osteoid osteomas develop is unknown, the process is clear. The osteoblasts divide uncontrollably, creating a hard, abnormal bone tissue mass (the tumor).
Osteoblastomas are slow-growing. Like an osteoid osteoma, osteoblastomas create hard, brittle bone. The problem with osteoblastomas is that they replace normal bone on a larger scale, predisposing the normal bone around the tumor to become weak and prone to fractures. The cause of osteoblastomas is unknown.
Symptoms of benign spinal tumors
Each person is different, and as such, not all will experience the same symptoms of benign spinal tumors. In general, however, many of these symptoms are similar for most spine tumor patients.
Some of the more common symptoms of benign spinal tumors include:
- Numbness or tingling in the hands, feet, arms and legs
- Pain in the area of the tumor
- Lumps or bumps under the skin (especially in the case of Schwannomas)
- A decrease in sensitivity to hot, cold or pain
- Compromised ability to walk
- Difficulty walking properly or keeping one’s balance
- Bowel or bladder incontinence
- Weakened bone around the tumor (in the case of osteoblastomas)
Diagnosing benign spinal tumors
The process for diagnosing benign spinal tumors can vary depending on the type of tumor that is present. Spinal tumor symptoms can be associated with other medical conditions, making a thorough physical and neurological exam vital.
Once these have been carried out, your doctor can determine which type or types of imaging studies would be the most useful.
MRIs, also known as magnetic resonance imaging, provide detailed images of nerves, spinal cord and spinal canal. It uses radio waves and a magnetic field to create these images. It is often the chosen test for diagnosing spinal tumors. In some instances, it will be used in conjunction with an intravenous contrast to help highlight abnormalities that might be difficult to see on a plain MRI.
A CT scan (computerized tomography) is another highly effective but lesser-used spinal tumor diagnostic tool. It uses a thin radiation beam that produces highly detailed images of structures in and around the spine and spinal canal. It, too, can be used with an injectable contrast to provide even more in-depth images of tumors and tissues.
If a suspicious area is seen on an imaging study, a biopsy may be performed. This involves harvesting a small amount of tissue from the tumor or lesion. This tissue is then sent to a pathologist who will examine it and perform tests to determine whether the cellular structure is that of a benign or malignant tumor.
Treatment options for benign spinal tumors
Your benign spinal tumor treatment will be determined depending on where it’s located, what types of symptoms it’s causing and whether or not it’s compromising any adjacent structures. Everything from monitoring to surgery is available, giving you a wide variety of options for treatment.
Monitoring and observation
This treatment is the most conservative of the benign spinal tumors treatments available. If you have a slow-growing tumor that is not compromising nerves or other structures in your body, this may be the first course of action your doctor will recommend.
You will undergo regularly scheduled imaging studies to ensure that the growth of your tumor isn’t causing problems. This also alerts your doctor to any changes that might indicate a malignancy developing.
Recovery: There is no significant recovery period from MRIs or CT scans. If you have had a contrast study done, you may be advised to rest for the remainder of the day.
If your spinal tumor is causing swelling, steroid injections may be recommended to help alleviate inflammation and discomfort.
Your doctor will inject the area in which the tumor exists with a steroid that will dampen the immune response that can cause inflammation.
Recovery: You may be a little sore at the injection site. Resting and cold compresses can help to address any discomfort you experience from the injection. You will likely be able to return to your normal activities the following day.
In some instances, your benign spinal tumor may need to be surgically removed or reduced in size. Intradural tumors (those that occur inside of the spine’s dura mater) require that the dura be able to recover. If you have an osteoblastoma that is compromising your spine’s stability, you may also need to undergo surgery to strengthen the bone and stabilize your spine.
The recovery period for surgery can vary depending on where your tumor is located, how large it was and what other procedures, such as a spinal fusion, may have been included.
In the case of intradural tumors, recovery from the surgery itself typically takes three to four weeks. In general, you’ll probably be fully recovered at around three months. If there were neurological implications caused by the tumor, recovery of functions may take a few months. It’s important to attend any and all physical therapy appointments to maximize the effects of your surgery.
Your neurosurgeon can provide you with a more accurate recovery timeline once you’ve been assessed and the surgical plan has been created.
Dr. Luigi Bassani is an accomplished board-certified neurosurgeon in Central Jersey and a proud member of Neurosurgeons of New Jersey, practicing out of their Livingston office. Dr. Bassani specializes in the diagnosis and treatment of a broad range of pediatric brain and spinal cord tumors and deformities including but not limited to pediatric epilepsy, cervical spine trauma, brain cancer, brain and skull growth abnormalities, and blood vessel disorders. In 2015 and 2017, he was named New Jersey’s Favorite Kids’ Docs for Pediatric Neurosurgery. Dr. Bassani also utilizes minimally invasive surgical techniques to treat adult patients suffering from brain tumors, herniated discs, and spinal trauma or degeneration. He’s accepting new patients.