Spinal cord tumors may develop within the Rückenmarkparenchyms while directly destroy the tissue or occur outside of the parenchyma and then compress frequently cord or nerve roots. Symptoms include increasing back pain and neurological deficits attributable to the spinal cord or spinal nerve roots. The diagnosis is made by an MRI. Treatment may corticosteroids include surgical excision and radiation therapy.
Spinal cord tumors can be intramedullary (within the Rückenmarkparenchyms) or extramedullary (outside the parenchyma).
Spinal cord tumors may develop within the Rückenmarkparenchyms while directly destroy the tissue or occur outside of the parenchyma and then compress frequently cord or nerve roots. Symptoms include increasing back pain and neurological deficits attributable to the spinal cord or spinal nerve roots. The diagnosis is made by an MRI. Treatment may corticosteroids include surgical excision and radiation therapy. Spinal cord tumors can be intramedullary (within the Rückenmarkparenchyms) or extramedullary (outside the parenchyma). Intramedullary tumors are the most common glioma (z. B. ependymomas, low-grade astrocytomas). Intramedullary tumors infiltrate and destroy the Rückenmarkparenchym; they can extend over many spinal cord segments or lead to a syrinx (syrinx of the spinal cord or brain stem). Extramedullary tumors These tumors may be intradural or extradural. Most intradural tumors are benign, usually is meningiomas and neurofibromas, the most common primary spinal tumors. Most extradural tumors are tumor metastases, usually from carcinomas of the lung, breast, prostate, kidney or thyroid or lymphoma (z. B. Hodgkin’s lymphoma, lymphosarcoma, reticulum cell sarcoma). Intradural and extradural tumors cause neurological damage due to compression of the spinal cord or nerve roots. Most extradural tumors infiltrate and destroy bones before they compress the spinal cord. Symptoms and complaints of pain is an early symptom, especially in extradural tumors. He is progressive, independent of activity and worsens when lying down. The pain can occur in the back and / or along the sensitive innervation of a particular broadcast dermatome (radicular pain). As a rule, eventually neurological deficits attributable to the spinal cord develop. Common examples are spastic paralysis, incontinence and dysfunction of some or all sensitive tracks in a specific spinal segment and below it. The deficits are usually trained bilaterally. Many patients with extramedullary tumors present with pain, but show some sensitive deficits of the distal lower extremities, segmental neurological deficits and symptoms of spinal cord compression or a combination thereof. The symptoms of spinal cord compression can deteriorate quickly and paraplegia and lead to the loss of bowel and bladder control. Symptoms of nerve root compression are also common; they include pain and paresthesia with subsequent sensory deficits, muscular weakness, and, in chronic compression, increasing muscle wasting along the innervation of the affected roots. Diagnosis MRI patients with segmental neurologic deficits or suspected spinal cord compression require emergency consistent diagnosis and treatment. The following speaks for spinal tumors: Progressive, unexplained or night back or nerve root pain Segmental neurological deficits unexplained neurological deficits attributable to the spinal cord or nerve roots. Unexplained back pain in patients with primary tumors of the lung, breast, prostate, kidney or thyroid or lymphoma. The diagnosis is made by a MRI of the affected area of ??the spinal cord. The CT with myelography is an alternative, but it is less accurate. If the MRI shows no spinal cord tumor, other spinal lesions have (z. B. abscesses, arteriovenous malformations, arteriovenous Fehlbildungen- (in the spinal cord AVMs)) and paravertebral tumors are considered. Radiographs of the spine, made for other reasons, a bone destruction, a broadening of the spinous processes or deformation of the paraspinal tissues can show, particularly when it is a tumor metastasis. Corticosteroids treatment excision, radiation therapy, or both in patients with neurological deficits treatment with corticosteroids (e.g., dexamethasone iv 100 mg, then 10 mg po 4 times / day) begun immediately to reduce the Rückenmarködem and to maintain the function , Tumors that compress the spinal cord, are treated as soon as possible. Some well localized primary spinal cord tumors can be surgically removed. The neurological deficits recede in about half of these patients. Tumors can not be removed surgically, radiation therapy is used, with or without surgical decompression. Compressing extradural tumor metastases are usually surgically removed from the vertebral body and then treated with radiotherapy. Nichtkomprimierende extradural tumor metastasis can be treated only with radiotherapy, but a failure of the irradiation, a surgical excision may be required. Conclusion spinal cord tumors may be located (outside of the parenchyma) intramedullary (within the Rückenmarkparenchyms) or extramedullary. Extramedullary tumors may be intradural or extradural. Most intradural tumors are benign meningiomas and neurofibromas, which are the most common spinal primary tumors; Most extradural tumors are metastatic. Enter patients with neurological deficits corticosteroids. Remove the spinal cord tumors surgically and / or put on radiotherapy.