3 Neurological Presentation and Clinical Diagnosis of Spine Tumors

Andrew M. Hersh, Abdel-Hameed Al-Mistarehi, Danielle Dang, and Daniel Lubelski

Abstract

The clinical presentation of spinal tumors consists of a broad array of signs and symptoms, reflecting the diversity of tumor types and locations within the spine. A comprehensive clinical history and physical examination is critical to facilitating an early diagnosis. Neck and back pain are common presenting symptoms in nearly all patients with spine tumors. Several red flags have been described that increase suspicion of a malignant cause compared to a degenerative cause. Compression of dorsal and ventral nerve roots can produce radiculopathy, which includes sharp pain, sensory loss, and/or weakness in a dermatomal or myotomal distribution. Direct compression or infiltration of the spinal cord can produce symptoms of myelopathy, including muscle weakness and bowel and bladder deficits. Several grading and scoring systems have been proposed to classify spine tumors, establish the prognosis, and determine the optimal treatment regimen. Clinical suspicion of a spine tumor should be followed by imaging studies, including plain radiography, computed tomography, or magnetic resonance imaging, which constitute the gold standard for workup.

Key words

spine - tumors - oncology - diagnosis - neurological examination

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