Primary Tumors of the Spine

✔ Primary spine tumors are relatively rare ✔ Cancer is a genetic disease ✔ The acquired capabilities of cancer are: self-sufficiency to growth signals, insensitivity to antigrowth signals, tissue invasion and metastasis, limitless replicative potential, sustained angiogenesis, evading apoptosis ✔ Spine tumors are classified based on the histology ✔ Pain, spinal deformity, and neurologic deficits frequently are presenting symptoms ✔ Age and location are important parameters for establishing a differential diagnosis ✔ CT and MRI are essential for systemic and surgical staging ✔ Biopsy is required to establish the tissue diagnosis ✔ The biopsy has to be placed so that it does not compromise subsequent surgical resection ✔ Do not rely completely on the result of the biopsy – the final histology may be different ✔ The “wait and see” approach is very rarely indicated ✔ Conservative treatment is only indicated for benign tumors and in asymptomatic patients ✔ Malignant tumors in general are treated surgically ✔ In sensitive tumors, chemoand radiotherapy are considered as an adjuvant treatment ✔ The goal of surgery is to remove the primary tumor in its entirety followed by stable reconstruction of the spine