Primary Tumours of the Spine

What are Primary Tumours of the Spine?

Primary tumours of the spine originate in the spine and are not those tumours that come from another place in the body and settle in the spine. They are rare – 0.04% of all tumours and 10% of all bone tumours.

How are Primary Tumours of the Spine diagnosed?

A high index of suspicion is required to make the diagnosis. Pain is the most common complaint being present in up to 85% of patients with a primary spine tumor. The pain is typically localized to the site of lesion and is characterized as progressive, gradual in onset, worse at night and non-mechanical. Weakness can be seen in up to 42% of patients and a mass is evident in up to 16% of patients. Three percent of patients are asymptomatic however.

Investigations include blood tests (full blood count, ESR, CRP) and imaging studies such as X-ray, CT, MRI, Bone scan

How are Primary Tumours of the Spine treated?

Benign primary tumors of the spine are slow-growing, well-circumscribed, usually occur in patients younger than 21 years of age, involve the vertebral body and posterior elements of the spine. The location of the tumour is an important factor in determining the type of tumour.
Examples include osteochondroma, osteoid osteoma, osteoblastoma, aneurysmal bone cyst, giant cell tumor, and eosinophilic granuloma.

Malignant primary tumors of the spine are fast-growing, invasive, and usually occur in patients older than 21 years of age
Examples include multiple myeloma/solitary plasmacytoma, osteosarcoma chondrosarcoma, Ewing's sarcoma/primitive neuroectodermal tumor, chordoma, lymphoma.