Characterization and Treatment of Spinal Tumors

Abstract

The prevalence of spinal tumors is rare in comparison to brain tumors which encompass most central nervous system tumors. Tumors of the spine can be divided into primary and metastatic tumors with the latter being the most common presentation. Primary tumors are subdivided based on their location on the spinal column and in the spinal cord into intramedullary, intradural extramedullary, and primary bone tumors. Back pain is a common presentation in spine cancer patients; however, other radicular pain may be present. Magnetic resonance imaging (MRI) is the imaging modality of choice for intradural extramedullary and intramedullary tumors. Plain radiographs are used in the initial diagnosis of primary bone tumors while Computed tomography (CT) and MRI may often be necessary for further characterization. Complete surgical resection is the treatment of choice for spinal tumors and may be curative for well circumscribed lesions. However, intralesional resection along with adjuvant radiation and chemotherapy can be indicated for patients that would experience increased morbidity from damage to nearby neurological structures caused by resection with wide margins. Even with the current treatment options, the prognosis for aggressive spinal cancer remains poor. Advances in novel treatments including molecular targeting, immunotherapy and stem cell therapy provide the potential for greater control of malignant and metastatic tumors of the spine.

Selective cargo sorting in stem cell‐derived small extracellular vesicles: impact on therapeutic efficacy for intervertebral disc degeneration

“…MSCs have been utilised in the therapeutic management of diverse diseases, encompassing musculoskeletal disorders, neurodegenerative diseases, shock, and tumors. [31][32][33] MSCs are commonly employed for the repair of tissues or organs through cell transplantation. 34 They serve as scaffolds to provide viable cells or bioactive molecules.…”

“…They also can serve as immune regulators by generating and secreting cytokines for the anti-tumour therapy. 31 Currently, MSCs have been used for intervertebral disc regeneration, mainly through cell differentiation or their paracrine effects. 35 The hallmark of IVDD is the degradation of ECM components and the infiltration of fibrosus tissues.…”

“…They serve as scaffolds to provide viable cells or bioactive molecules. They also can serve as immune regulators by generating and secreting cytokines for the anti‐tumour therapy 31 . Currently, MSCs have been used for intervertebral disc regeneration, mainly through cell differentiation or their paracrine effects 35 .…”

Predicting survival of patients with bone metastasis of unknown origin

“…Bone is the third most common metastatic site following the liver and lung (10). Cancer of unknown origin refers to malignancies, where metastases are histologically confirmed, but where no primary site can be identified on the basis of a comprehensive clinical and imaging evaluation (11)(12)(13).…”

Spinal Intradural Tumor Resection via Long-Segment Approaches and Clinical Long-Term Follow-Up

“…The primary therapy consists of surgical resection, which includes different approaches. Most commonly, interlaminar fenestration, hemilaminectomy, laminectomy, and laminoplasty are used without spinal fusion [5][6][7]. However, some tumors require extensive resection via multiple segments, i.e., equal to or above four segments.…”