A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing) of the skin, mucous membranes and sclerae (white part of the eye). Inspection and palpation (palpation) of the lymph node stations (cervical, axillary, supraclavicular, inguinal). Inspection and palpation of … Spine Tumors: Examination
Medical history (history of illness) represents an important component in the diagnosis of tumors of the spine. Family History Is there a frequent history of tumors in your family? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). Was there a precipitating event for the back pain? How long have they existed? Do they … Spine Tumors: Medical History
Musculoskeletal system and connective tissue (M00-M99). Aneurysmal bone cyst (AKZ) – tumor-like osteolytic lesions (“bone loss”) with dark red to brownish cavities up to 14 cm3 in size. Paget’s disease (osteodystrophia deformans) – bone disease leading to bone remodeling and gradually thickening of several bones, usually the spine, pelvis, extremities or skull. Pathological fracture – … Spine Tumors: Or something else? Differential Diagnosis
The sequelae or complications of tumors of the spine vary widely. The various factors are: Tumor type, general condition, number of bony lesions, presence of organ metastases, type of primary tumor, and neurologic disorders. Musculoskeletal system and connective tissue (M00-M99). Chronic back pain Neoplasms – tumor diseases (C00-D48) Pulmonary metastases in osteosarcoma and Ewing’s sarcoma. … Spine Tumors: Consequential Diseases
Malignant (malignant) solid neoplasms Chondommyxoid sarcoma Chondrosarcoma Chordoma Ewing’s sarcoma – predominantly children and adolescents between the ages of 10 and 18; other locations: Humerus (upper arm bone), ribs, femur (thigh bone), and fibula (fibula bone). Fibrosarcoma Hemangiosarcoma Malignant fibrous histiocytoma Osteosarcoma – predominantly adolescents and young adults (60% under 25 years of age); other … Spine Tumors: Classification
Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Alkaline phosphatase (AP) isoenzymes, ostase, urinary calcium (tumor hypercalcemia (synonym: tumor-induced hypercalcemia (calcium excess), TIH) is one of the most common symptoms in paraneoplastic syndromes), PTHrP (parathyroid hormone-related protein; the constellation … Spine Tumors: Test and Diagnosis
Therapeutic Targets Relief of pain Prevention or improvement of existing neurological deficits. Stabilization of fracture-prone spinal sections Therapy recommendations Analgesia according to WHO staging scheme: Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. Chemotherapeutic agents are used as an independent form of … Spine Tumors: Drug Therapy
Obligatory medical device diagnostics. Conventional radiography of the affected body region, in two planes – as primary diagnostics. Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging (using magnetic fields, i.e., without X-rays)) of the spine – as the method of choice. Optional medical device diagnostics – depending on the results of the medical history, physical examination … Spine Tumors: Diagnostic Tests
For benign (benign) tumors, complete excision is the goal. For malignant (malignant) tumors, the goal is removal in healthy tissue with a safety margin. The following forms of surgical therapy are available and are performed depending on the exact type of tumor. Biopsy (tissue removal) to clarify the dignity (biological behavior of tumors; that is, … Spine Tumors: Surgical Therapy
Depending on the type of tumor, radiation therapy (radiotherapy, radiatio) – with curative (curative) as well as palliative (disease-moderating) intent – may be used, possibly in combination with surgery: In the therapy of metastases (daughter tumors) of radiation-sensitive primary tumors such as lymphomas, prostate tumors, or germ cell tumors, radiation therapy is of great importance … Spine Tumors: Radiotherapy
The following symptoms and complaints may indicate tumors of the spine: Back pain (marked pain; caused by osteolysis/bone dissolution, occurring mainly at night with a probing, gnawing character, which wakes patients during sleep). Location of back pain suggests quite accurately the location of the tumor. Numbness and paresis (paralysis) as signs of spinal cord compression; … Spine Tumors: Symptoms, Complaints, Signs
Pathogenesis (development of disease) The pathogenesis of tumors of the spine, like the types of tumors, is very diverse. Etiology (causes) Biographic causes Genetic burden from parents, grandparents – possible depending on tumor type. Age – increasing age (incidence (frequency of new cases) of metastases (daughter tumors) increases).
