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Spine tumors

For the distinction between primary spinal tumors, ie tumors that arise in the spine and secondary, ie metastases another tumor, where the tumor cells was abducted by the blood to the spine and settle there.
Primary spinal tumors are relatively rare. They grow in the vertebral body, and can kill or those that grow out of the area and thus lead to defect formation and deformation. It is especially fatal when tumor tissue grows into the spinal canal, it can lead to compression of the spinal cord or spinal nerves, which can at worst cause paraplegia.
There are benign and malignant spinal tumors. Benign spinal tumors include: osteoid osteoma, osteoblastomas, hemangioma, fibrous histiocytoma, aneurysmal bone cyst, and eosinophilic granulomas. Typical symptoms are pain, rare neurologic deficits. Often it is incidental findings. The therapy is based on the natural course, ie first follow-up. Depending on the direction of growth, e.g. Spinal canal is also considered an operation. Malignant spinal tumors are Ewingsarkome eg, osteosarcoma and chondrosarcoma rare. They require radical therapy with a total removal of the tumor as possible, including most of the entire vertebral body, which is often very difficult, sometimes impossible. Following the surgery, irradiation, chemotherapy or sometimes even a combination of both is largely required.

Metastases occur in the spine relatively frequently. Again, it can lead to a destruction of the vertebral body with corresponding defect formation and deformation are also paraplegia due to ingrowth of the tumor in the spinal canal are a known risk. The most common tumor types, which may have metastases in the spine are: breast cancer, prostate cancer, lung cancer and kidney cancer.
The exact origin of the metastases is unclear. One possible mechanism is that of the original tumor, which sits outside of the spine, tumor cells releases, and this of him solve (fall), which then circulate in the blood stream (float). The bloodstream, these tumor cells can enter into a vertebral body. There they find good growth and nutrient conditions and adhere. The cells multiply and form more and larger organizations. The tumor cells grow uncontrollably and evade the immune system. Then they gradually destroy the healthy bones and vertebrae make unstable. As a result of this loss of strength may then also come to vertebral fractures, the so-called pathological fractures. Wirbelkörpermetasten often occur in the final stage of a tumor disease, where the patient is generally very weak and metastases were detected already at other points of the spine or in other organs. Thus, the therapeutic options are very limited.

Spine tumors

Diagnostics
In clinical diagnosis, we assessed the function of the spine and the gait pattern . Essential is a neurological examination. Impaired mobility and pain with local tenderness also comprise a lesion in the spine, which may be a tumor. In the X-ray examination of disintegration or hardening of the vertebral body can be seen.
The exact extent of the tumor and the tumor reference to neighboring structures can be computed tomography ( CT) and Magnetic Resonance Imaging ( MRI) assessment . In CT you can see better bone structures and assess where dissolution features are . On MRI , the soft tissue form from better and it looks better the tumor in the spinal canal . The delineation of normal tissue can be enhanced by contrast medium .
By a bone scan even very small tumors can be detected elsewhere . It is a very sensitive method , allowing an overview of the entire skeletal system
By positron emission tomography (PET ) in conjunction with a CT very small herd , which are located in PET can be mapped topographically better. This is a very modern method.

Conservative treatment
A conservative therapy for tumors restricted sense. Here, the general condition , age, tumor type and tumor size play a role. Benign tumors are usually removed . At older ages, small tumors that can not make any complaints are also awaited. Through regular follow-up, tumor growth can be assessed and decided when an operation is useful.
In the presence of malignant tumors , conservative treatment is indicated when the tumors on the one hand respond well to chemotherapy or radiation therapy, or if there is no improvement in the condition more can be achieved by surgery. Also analgesic drugs are useful because tumors in the spine can cause a lot of pain. Sometimes radioactive substances are used to kill tumor cells.

Surgical treatment
Surgery in the treatment of tumors have a different meaning or purpose . If the spinal cord is depressed and possibly neurologic deficits are present, such as Paralysis, then it is the spinal cord to relieve and prevent paraplegia, even if the tumor may not be completely removed , the prognosis is not significantly improved, but can be preserved quality of life. If the tumor has destroyed the very bone and thus it has already come to breaks , then stabilization operations can be useful . This pain can be reduced and possibly also prevents paralysis. Optimally, it is of course, if the tumor can be completely removed by surgery. This applies to so-called benign and malignant tumors. Unfortunately, it does rather rare for malicious but unfortunately not always the benign tumors , so that even after surgery, the risk of recurrence, ie recurrence of the tumor is.