What are spinal tumors?

Spinal tumors develop when the healthy, normal cells inside and around the spine begin to grow and function differently. These cells begin to form growths of tissue in the bones of the spine (vertebrae) or near the spinal cord. Pediatric spinal tumors typically occur in children between ages 10 and 16 and are less common than pediatric brain tumors.

About 90 percent of spinal tumors begin by growing in the cells next to the spinal cord, while the remaining 10 percent grow in cells within the spinal cord. 

Spinal tumors can vary in degrees of aggressiveness: lower-grade (less aggressive) or higher grade (very aggressive). Our dedicated pediatric neurosurgery team will analyze the grade of your child’s spinal tumor to determine its rate of progression: 

• Grades I and II are considered lower-grade tumors. These tend to grow more slowly and are less likely to affect nearby tissues. 
• Grades III and IV are higher-grade tumors, which tend to grow more quickly. These may grow into nearby tissues and often require a higher level of care and treatment. 
  
  

Some spinal tumors are malignant, which means they are cancerous, while others are benign, or non-cancerous.

Main types of spinal tumors in children:

• Meningioma is a tumor that grows on the outer layers of tissue covering the spinal cord and the cerebrospinal fluid (CSF). These tumors are usually noncancerous. Surgery is typically used to treat these tumors.
• Neurofibroma is a tumor that usually involves the nerves coming out of the spinal cord. They can be found as part of neurofibromatosis disease and treatment may involve surgery and/or radiation therapy.
• Schwannoma, like the neurofibroma, is a tumor that tends to rise from the nerves along the spinal cord. Symptoms can include localized pain, and treatment often involves surgery. 
• Malignant nerve sheet tumors are aggressive tumors often treated with surgery and radiation therapy with or without chemotherapy.
• Ewing's sarcoma is a rare tumor that can grow in the bones or on the soft tissue surrounding bones. Generally affecting those between the ages of 10 and 20, treatments will depend on the tumor’s location, size and severity and may include chemotherapy, radiation or surgery.
• Ependymoma is a type of tumor that forms within the spinal cord. It is typically easily diagnosed from an MRI scan and can be treated with a combination of surgery, chemotherapy and/or radiation therapy.
• Astrocytoma is the most common spinal cord tumor in children. Surgery is the main course of action with further treatment including radiation therapy and chemotherapy needed in some cases.
• Hemangioblastoma is relatively rare in children and may sometimes occur as part of a genetic condition called Von Hippel-Lindau disease. The main treatment is surgery.
  

What are the signs and symptoms of spinal tumors?

If your child has a spinal tumor, their symptoms will vary based on the tumor’s location. Common pediatric spinal tumor symptoms may include: 

• Back pain
• Muscle weakness in the arms or legs and sometimes in both
• Numbness or tingling in the arms and legs 
• Poor bladder or bowel control
• Scoliosis

Some of these symptoms may not indicate a spinal tumor and can have other causes. If your child is experiencing any of these symptoms, or if they haven’t gone away or have been getting worse over time, it’s time to speak with their doctor.

Diagnosing spinal tumors

While most spinal tumors are benign (non-cancerous), some may be cancerous and can grow back after they’re removed. Our skilled, compassionate pediatric neurosurgery team will work to diagnose, treat and monitor your child’s condition.

To diagnose whether your child has a spinal tumor, our team will perform tests that may include:

• Physical exam: A doctor will conduct a series of tests on your child's muscles, movement and functioning.
• Magnetic resonance imagining (MRI): MRIs use powerful radio waves and magnets to create detailed, 3D images of the brain.
• Computerized tomography (CT or CAT) scans: CT scans use X-rays to obtain cross-sectional images of the brain. 
• Spinal taps: A spinal tap allows the doctor to remove fluid from the spine to help make a diagnosis.
• Bone scans: Bone scans are nuclear imaging tests that help our team make a diagnosis.
• Biopsies: A biopsy is the removal of tissue that allows our team to make a diagnosis and analyze the stage of any present disease. 
  
  

How are spinal tumors treated?

Whether you’re coming to Geisinger’s pediatric neurosurgery team for a first-time diagnosis or a second opinion, the treatment of your child’s spinal tumor will depend on their diagnosis. Treatment options may include surgery, chemotherapy and/or radiation therapy. Sometimes, a child’s spinal tumor may come back after initial treatment. If this happens, additional treatment such as surgery, chemotherapy or radiation may be necessary.

Our pediatric neurosurgery team will consider the tumor’s location, type and progression and your child’s overall health to determine the best course of treatment. Using a team approach, we provide your child with specialized and personalized care unique to their individual needs.

Our team is in constant collaboration with centers for pediatric neuro-oncology, which allows us to deliver the latest, most advanced treatments to children.