Spine Metastases

What is a spine metastasis?

Metastasis means the spread of cancer cells from tumors in other parts of the body. Bone metastases occur when tumor cells migrate from the original tumor site and cause a secondary tumor in the bones. The spine is a common location for new tumors, or metastases, to form.

Metastatic spinal tumors, also known as spinal metastases, are the most common tumors found in the spine, accounting for approximately 90% of masses encountered during spinal imaging. These tumors occur when cancer cells from a primary tumor site spread to the spine, typically through the bloodstream. The spine is the third most common site for cancer metastasis, following the lungs and liver. Spinal metastases are more frequently found as bone metastasis, although they can also involve the epidural space, leptomeninges, and spinal cord. About 30-70% of cancer patients develop spinal metastases during the course of their disease. The thoracic spine is the most commonly affected region, accounting for 60-70% of cases, followed by the lumbar spine (20%) and cervical spine (10%). Patients with spinal metastases may experience symptoms such as back pain, neurological deficits, and spinal instability. Magnetic resonance imaging (MRI) is the gold standard for diagnosing spinal metastases, with a key feature being the sparing of intervertebral disc spaces.

Some types of cancers, especially those of the breast, prostate, lung, thyroid, and kidney, are more likely to spread to the spine.

Symptoms

• Back pain
• Bowel and urinary incontinence
• Arm or leg weakness
• Hypercalcemia (high levels of calcium in the blood).
• Hypercalcemia can cause nausea and vomiting, constipation, and mental confusion.
• Metastasized tumors can cause pain and fractures in the spine.

Treatment

Diagnosis is made through various types of imaging, including X-ray, bone scintigraphy (bone scan,) CT scan, PET scan, or MRI.

Treatment is varied and is designed for each individual. It may include osteoporosis medications to strengthen bones, chemotherapy to fight cancer cells, and steroids to reduce inflammation. All of these help to reduce pain, as well. Radiation therapy and surgery may also be used.