Treatment of Primary Vertebral Tumors

Abstract

Advances in the treatment of disease and detection through advanced imaging have led to an increase in the discovery of vertebral tumors. Although the majority of symptomatic spinal lesions are metastatic in origin, a significant number of them arise primarily in the spine. These lesions encompass a wide variety of tumor types classified by their cell of origin: bony tumors, cartilaginous tumors, vascular tumors, plasma cell dyscrasias, and tumors that arise from embryonic rests. Further classification of these tumors into malignant or benign subtypes is based on their clinical progression, histopathological evidence of invasiveness, and response to therapy. We provide a brief overview and description of primary tumors as well as treatment paradigms for the individual tumor types. Mt Sinai J Med 76:499-504, 2009. (c) 2009 Mount Sinai School of Medicine.

Solitary Plasmacytoma of the Thoracic Spine

“…They occur in patients at a mean age of 55 years and are up to 2-3X more common in males [6,7]. This contrasts the demographics which characterize patients with multiple myeloma which occurs most commonly in the 6 th -7 th decade and has an equal gender distribution [8]. The plasmacytoma is however regarded as a precursor of multiple myeloma demanding effective management to avoid progression which occurs in over 50% of cases with 5 years [1,2].…”

Back pain in children and adolescents

“…Osteoid osteoma accounts for approximately 1% of all spinal tumours and 11% of all primary benign tumours in patients between the ages of ten and 25 years. 72 A scoliosis develops because the asymmetric involvement of the vertebra gives rise to muscle spasm. Patients typically have back pain at night, which is relieved by NSAIDs and aspirin.…”

“…Definitive treatment is by surgical resection, which is both curative and pain-relieving. 72 Thermal ablation therapy (radiofrequency ablation or cryoablation) has been shown to be an effective minimally invasive alternative to excision. 73 Osteoblastoma accounts for 1% of all primary benign tumours, and more than 40% are located in the spine.…”

“…73 Osteoblastoma accounts for 1% of all primary benign tumours, and more than 40% are located in the spine. 72 It is larger than an osteoma and usually > 2 cm in diameter. Its location is similar to that of osteoid osteoma, the lamina and pedicle being the most frequent sites (Fig.…”

C2 Solitary Bone Plasmacytoma Curettage and Vertebral Augmentation in an 83-Year-Old Female: Case Report and Review of Surgical Treatment Approaches in the Spine

“…When compared to multiple myeloma, SBP occurs more frequently in younger patients and has a much better prognosis [ 1 , 2 ]. SBP has a 2-3 times higher incidence in males compared to females, whereas multiple myeloma displays an equal gender incidence [ 3 ]. Patients typically present with severe neck pain with movement before the onset of neurologic symptoms [ 2 , 4 ].…”