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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on April 2, 2021.

About spinal cancer

Primary spinal cancer develops from cells within the spinal cord or in the surrounding structure of bones, tissues, fluid and nerves.

Along with the brain, the spinal cord forms part of the central nervous system (CNS). The spinal cord is a column of nerve tissue that extends from the base of the brain down the back. It is surrounded by three protective membranes and is enclosed within the bones of the spine (vertebrae). It carries important messages between the brain and the rest of the body.

In 2021, an estimated 24,530 new cancers of the brain or spinal cord will be diagnosed in the United States, according to the American Cancer Society. Spinal cancer is a relatively rare condition, with about 1 in 140 men and 1 in 180 women developing the disease in their lifetime. Brain tumors are more common than spinal tumors.

Primary spinal cord or column tumors are tumors that form from cells within the spinal cord itself or from its surrounding structures. Most tumors of the spine are metastatic tumors, which spread to the spine from another part of the body. Metastatic tumors occur in the central nervous system about 10 times more frequently than primary tumors.

What causes spinal cancer?

The causes of spinal tumors are still largely unknown. Although some genetic conditions may contribute to the development of spinal cancer, the risk factors are much less defined for spinal cancer than for other forms of cancer.

Known risk factors for spine cancer include:

  • Prior history of cancer, with breast cancer, lung cancer, prostate cancer and multiple myeloma most likely to spread to the spine
  • Compromised immune system
  • Hereditary disorders, including Von Hippel-Lindau disease and neurofibromatosis (NF2)
  • Radiation therapy exposure
  • Chemical exposure, including to industrial chemicals

Who gets spinal cancer?

There is no clear picture of any group of individuals more at risk for spinal cancer, other than statistics that show men are diagnosed with the disease at a slightly higher rate than women. Having some hereditary diseases, a compromised immune system, previous radiation therapy or exposure to some chemicals may increase the risk of developing spinal cancer.

Types of spinal tumors

Most tumors on the spine metastasize to the spine from elsewhere in the body.

Cancers that appear in the central nervous system as primary spinal tumors may include:

  • Chondrosarcoma, a type of bone cancer that forms in cartilage
  • Chordoma, a type of bone cancer that commonly appears in the sacrum, in the lower back at the base of the spine
  • Ewing sarcoma, a type of bone cancer that affects the bone and surrounding soft tissue
  • Lymphoma (also called primary non-Hodgkin lymphoma or extranodal lymphoma), a type of cancer that affects lymphocytes, the cells of the immune system
  • Multiple myeloma, a type of blood cancer that affects plasma in the blood cells
  • Osteosarcoma, a type of bone cancer that weakens the bone

Many spinal tumors are benign (non-cancerous), but they may also cause serious problems as they grow and put pressure on spinal tissue and nerves. Common types of benign tumors of the spine include ependymomas, astrocytomas, meningiomas, schwannomas and hemangioblastomas.

Spinal cancer tumors are sometimes divided into the four regions where they may occur:

  • Extradural tumors (also called epidural tumors), which form inside the spinal column, often in the space surrounding the outer membrane (dura)
  • Intradural tumors, which form inside the dura
  • Intramedullary tumors, which are intradural tumors that grow inside the spinal cord
  • Intradural-extramedullary tumors, which are tumors that form in the meninges outside the spinal cord

Spinal cancer symptoms

The most noticeable sign of spinal cancer is pain. Pain may come from the tumor's location in the spinal column, as it pushes on sensitive nerve endings or causes spinal instability.

When the tumor presses on the spinal cord, symptoms may begin with numbness or tingling in the arms or legs. Next, spinal cancer patients may experience clumsiness, an unease from not knowing where their feet are, and difficulty with buttons or keys. Spinal cancer symptoms may grow to include weakness, inability to move the legs and potentially paralysis.

Some common signs of spinal tumors may include:

  • Back pain
  • Pain in the neck, arms or legs
  • Muscle weakness or numbness in the arms or legs
  • Difficulty walking
  • General loss of sensation
  • Difficulty with urination (incontinence)
  • Change in bowel habits (loss of bowel control)
  • Paralysis to varying degrees
  • Spinal deformities
  • Pain or difficulty with standing

Diagnosing spinal cancer

Tests and tools for diagnosing spinal cancer may include:

  • Angiography
  • Lumbar puncture, also called a spinal tap
  • Nuclear medicine bone scan
  • Magnetic resonance imaging (MRI)
  • Computed tomography scan (CT scan)
  • Positron emission tomography (PET)/CT scan
  • X-ray

Spinal cancer treatments

Treatment options for spinal cancer may include:

  • Surgery, which may be used to:
    • Remove a cancer cells from one portion of the spinal column
    • Relieve symptoms of a metastatic spinal tumor
    • Remove tissue pressing up against the spinal cord and nerves
    • Relieve the buildup of cerebrospinal fluid
  • Chemotherapy
  • Radiation therapy
  • Interventional radiology, including taking biopsies, delivering treatment directly to spine tumors, providing palliative treatment and monitoring response to treatment
  • Kyphoplasty and vertebroplasty for treating compression fractures of the spinal vertebrae
  • Targeted therapy, including monoclonal antibodies, which work to stop the formation of new blood vessels (angiogenesis) that a tumor needs to grow