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Metastatic Spine Cancer

Metastatic Spine Cancer Overview

Metastatic spine cancer occurs when cancer cells spread to the spine from elsewhere in the body via the bloodstream. Metastatic spine cancer can develop in any region of the spine, including:

  • Cervical spine (neck)
  • Thoracic spine (mid-back)
  • Lumbar spine (lower back)
  • Sacrum (base of the spine)

Metastatic spine cancer can also be categorized in the following ways:

  • Intradural-extramedullary — a tumor inside the thin covering of the spinal cord, known as the dura
  • Intramedullary — a tumor within the spinal cord itself
  • Extradural — a tumor outside of the spinal cord and its dura but within or surrounding the bony spinal column

Metastatic spinal tumors are also known as secondary spinal tumors, whereas tumors that originate in the spine are known as primary spinal tumors.

Anatomy of the Spine

Your spine is made up of 33 vertebrae divided into five different segments, which are listed below in order from your head to your legs:

  1. Cervical, or the neck
  2. Thoracic, the middle of the back
  3. Lumbar, or lower back
  4. Sacrum, where the spine connects to the hips
  5. Coccyx, the tailbone

Metastatic spine cancer can occur in any segment of the spine, though metastatic cancer of the lumbar spine is the most common.

the segments of the spinal column including the cervical, thoracic, and lumbar segments along with the sacrum and coccyx
This illustration shows the segments of the spine along with the areas of the body that can be affected by injuries and diseases in each segment.

Metastatic Spine Cancer Symptoms

Symptoms of metastatic spine cancer vary depending on the location, size, and type of tumor. They may include:

  • Acquired spinal deformities
  • Decreased sensitivity to pain or temperature
  • Difficulty walking or balancing
  • Loss of bowel or bladder function
  • Numbness or weakness in the legs, arms, or chest
  • Stiffness or pain in the neck or back
  • Paralysis

Metastatic Spine Cancer Treatments

Depending on the size, type, and location of the tumor, treatment may include the following:

Neuro-Rehabilitation for Metastatic Spine Cancer

During and after treatment for metastatic spine cancer, neuro-rehabilitation may help you regain function and independence. Rehabilitation does not reverse damage to the spinal nerves, but it can help you achieve the best possible long-term outcome.

Each patient’s rehabilitation journey is unique, but it may include:

  • Physical therapy to help you regain lost muscle strength and motor skills
  • Occupational therapy to help you return to everyday activities at home in and in the community
  • Recreation therapy to enhance your overall quality of life

Common Questions about Metastatic Spine Cancer

How common is metastatic spine cancer?

It is estimated that between 30 and 70 percent of people with cancer develop a spine metastasis. Extradural tumors are the most common type of spinal tumors, and intramedullary tumors are the least common.

What causes metastatic spine cancer?

Metastatic spine cancer occurs when cancer spreads to the spine from another part of the body. Cancer is caused by mutations to the DNA within cells. There are many possible risk factors for cancer, including lifestyle factors and family history.

Who gets metastatic spine cancer?

Metastatic spine cancer can affect anyone. The following cancers are the most likely to spread to the spine:

  • Breast
  • Lung
  • Prostate

Other cancers that can spread to the spine include:

  • Gastrointestinal cancers
  • Kidney cancer
  • Lymphoma
  • Melanoma
  • Multiple myeloma
  • Sarcoma
  • Thyroid cancer

How is metastatic spine cancer diagnosed?

Your doctor may use any of the following to diagnose metastatic spine cancer:

  • Medical history
  • Physical examination to check vital signs
  • Neurological examination to evaluate pain and function
  • Imaging tests, such as magnetic resonance imaging (MRI), computed tomography (CT), or X-ray to look for tumors and problems with the bones of the spine
  • Biopsy to evaluate tumor tissue under a microscope

Information and Resources for Metastatic Spine Cancer

American Association of Neurological Surgeons

Group 49
Between 200,000 and 300,000 people each year will be diagnosed with a tumor that has metastasized to the brain, spinal cord, or peripheral nerves.

References

  1. Redmond KJ, Lo SS, Soltys SG, Yamada Y, Barani IJ, Brown PD, Chang EL, Gerszten PC, Chao ST, Amdur RJ, De Salles AA, Guckenberger M, Teh BS, Sheehan J, Kersh CR, Fehlings MG, Sohn MJ, Chang UK, Ryu S, Gibbs IC, Sahgal A. Consensus guidelines for postoperative stereotactic body radiation therapy for spinal metastases: results of an international survey. J Neurosurg Spine. 2017 Mar;26(3):299-306. doi: 10.3171/2016.8.SPINE16121. Epub 2016 Nov 11. PMID: 27834628; PMCID: PMC5551391.
  2. Wilson DA, Fusco DJ, Uschold TD, Spetzler RF, Chang SW. Survival and functional outcome after surgical resection of intramedullary spinal cord metastases. World Neurosurg. 2012 Feb;77(2):370-4. doi: 10.1016/j.wneu.2011.07.016. Epub 2011 Nov 7. PMID: 22120329.
  3. Anwar M, Barani IJ. Role of stereotactic body radiotherapy in spinal metastasis and subsequent fracture risk: identifying and treating the at-risk patient. CNS Oncol. 2013 Sep;2(5):437-45. doi: 10.2217/cns.13.31. PMID: 25054666; PMCID: PMC6136102.
Medically Reviewed by Igor Barani, MD on August 18, 2022