Incidence of spine tumours has been increasing day by day. Presently the incidence of spinal tumours is 5-10% of skeletal tumours. Spinal tumours may arise from vertebral column and /or spinal cord. These group of tumours can be benign (80-85%) or malignant (10-15%). Primary bone tumours and Metastatic bone tumours are named according to the epicentre of origin.
Primary bone tumours are the ones which arise from vertebra of spine. Different primary bone tumours like osteoid osteoma, osteoblastoma etc are benign in nature and tumours like osteosarcoma, chondrosarcoma etc are malignant in nature. Metastatic bone tumours are the ones which have their primary elsewhere in the body such as prostate, lung, breast etc and have their secondaries in the spine. Those tumours which arise from spinal cord are known as intra-dural tumours and they are further classified to extra medullary and intramedullary based on the origin of tumour tissue.
Although some are incidental findings, some cause local pain, radicular symptoms, neurologic compromise, spinal instability and deformity. After thorough clinical examination by a spine surgeon, a spectrum of investigations are advised to know the insights of underlying disease process. These investigations include various blood tests, x-rays, CT scan, MRI, bone scan, PET scan which in-total give a diagnosis.
Depending on the tumour pattern, further management is advised by the treating spine surgeon. The management of spine tumours is usually multi-disciplinary. Spine surgeon, Radiologist, Medical oncologist, Radiotherapist, Physiotherapist all have a role in management of spinal tumours. Management of spinal tumours include surgical procedures, radiation, chemotherapy based on the pathology detected. Biopsy is a procedure that is performed to get the conclusive diagnosis. Surgical procedures depend on tumour location, diagnosis, clinical condition of the patient. Stabilisation is usually done with decompression to make space for the spinal nerves and the tumour is removed in total or piece-meal.
Emerging technology like O-arm, navigation, neuromonitoring, bone scalpel have changed the practice of spinal tumours in a big way. Safety and precision have increased to a big extent in providing a better care to the patient.
