As the spinal cord is a rigidly enclosed cavity an expanding disease process will eventually

cause cord or root compression.

Manifestations of cord and root compression depend upon the following
Site root LMN
segmental UMN
Level above L1 vertebral body may damage both roots and cord bellow compress only roots.
Vascular involvement.
Speed of onset
1-15% of primary CNS tumors are intra-spinal.
2-Most of tumors are benign.
3-most present by compression rather than invasion
4-male\femal =5\4
5-75% is benign
6-1% of all tumors body
7-location: thoracic 48% lumbar 26% cervical 19%
8- multiple in 1%
May be classified in three groups:

NB: metastasis may be found in each category but they

are usaully ED
1-extradural:
a-metastasis:
b-primary spinal tumors:
Chordoma, osteoma, neurofibroma…
c-miscellaneous: plasmocytoma,multiple myeloma
granuloma….
2-intradural extramedullary spinal cord tumors:
a-meningioma,neurofibromas,lipomas,mesicellaneous.
3-intramedullary spinal cord tumors: astrocytoma,ependymoma
miscellaneous…
Depend upon:
Root
sever , sharp, shooting, burning pain radiating the cutaneous distribution or
muscle group supplied by the root . aggravated by movement , straining , or
coughing.
Segmental :
continuous, deep aching pain radiating into whole leg or one half of body not
affected by movement.
Bone :
contiuous , dull , and tenderness over the affected area may or may not be
aggravated by movement.
Lateral compressive lesion:
Root\segmental damagies or in area supplied by root but ovelape from adjucent
roots may prevent detection
weakness in group supplied by the involved root and segment with lower motor
neuron signs . wasting loss of tone fasciculation diminished or abscent reflexes.
NB: motor dificit is seldom detected in roots above C5 and from T2-L1
Sensory deficit of all modalities or hyperesthesia supplied by root but ovelape
from adjucent roots may prevent detection.
1-pain: the most common complaint. NB:onset usaully insidious but
a- radicular: abruptness occurs.
b-local : stiff neck or back . Valsalva maneuver increased. NB: nocturnal pain suggests SCT
c-medullary as in syrinx :oppressive , burning , dysesthtic , non-radicular.
2-motor disturbances:
a-weakness
b-gait disturbances
c- syringo -meylic syndrome: suggests IMSCT. UE segmental weakness, decreased DTR, dissociative
anesthesia.
Long-tract involvement clumsiness and ataxia(distinct from weakness)
d-atrophy , muscle twitches , fasciculations.
3-non-painful sensory disturbances:
a-dissociated sensory loss: decreased pain and temperature , preserved light touch (Brrwon-Sequard
synd.).
b- paresthesia radicular or medullary distribution.
4-sphincter disturbances:
5-miscellaneous symptoms:
a-scoliosis SAH visible mass over spine.
Temporal progression has been divided into
4 stages:
1-pain only.
2-Brown-Sequard synd.
3-incomplete trans sectional dysfunction.
4-complete trans sectional dysfunction.
1-x-ray.
MRI and CT:
3-myelography.
4-spinal ang.
5-lumbar puncture.
1-surgical
Decompressive laminectomy.
Radiotherapy and chemotherapy.
Prognosis:
1-neurofibroma:
a-Neurofibrosarcoma b-neurofibromatosis c-schwanomas
2-glumus tumor:
3-neuroma:
1-ganglioneuroma:
2-Neuroblastoma:
3-Pheochromcytoma:
4-Carotid bodytumor:
5-Glomus jugular tumor: