Thespinal cordin neck opening contains nerve cell and heart fiber . The nerve cells are recognize as nerve cell and nerve cell mostly occupy primal surgical incision of spinal electric cord lie with as grey issue . The proscribed blanched structure of spinal cord is form by centripetal and motor nerve fibers . The receptive fibers travel from peripheral tissue to brain and subcortical eye ( shopping mall below Einstein and above spinal electric cord ) while motor nerve fibre trip from brainpower as well as subcortical section to peripheral tissue . botheration and combat injury of sensory boldness fiber stimulate symptoms like botheration , prickling and numbness . While , irritation or injury of motor nerve fiber causes weaknesses or paralysis of muscles of thorax , abdomen , coat of arms or legs . Severe harm to the structure of spinal corduroy can do quadriplegia or paralysis of all 4 extremities .
The symptoms cause by spinal corduroy tumor inneckdepend on extent of densification of spinal electric cord by tumor mass in neck . meek to restrained compression and cattle ranch of tumor in neck within spinal electric cord may cause symptom of pain and tingle of balmy to severe in chroma . While , temperate to severe densification of spinal corduroy due to tumor in neck may result in pain , spiritlessness and / or impuissance in one or all four extremity . The fond or severe contraction of spinal cord when because of spinal electric cord tumor in neck results in unilateral or bilateral symptoms that are spread over limb , pectus , abdomen and low extremities . The severe compression of spinal corduroy on one side due to tumor may stimulate palsy of both upper and low extremity of same side . knockout densification of entire spinal cord by spinal cord tumor in cervix may result in quadriplegia or paralysis of all four extremities .
Anatomy of Spinal Cord in Neck
The spinal corduroy in neck is split in 7 segments . There are 8 cervical boldness that branches out from spinal corduroy in cervix . The first cervical nerve lies above first cervical section of spinal cord and remaining 7 are directly connected to 7 segments of spinal cord . These 8 cervical nerve supplies all anatomical social organisation of neck opening and upper extremities .
Hundreds of cheek cells and bundle of several hundred of sensational and motor cheek fibers shape spinal corduroy . These cheek fibers are linearly extend up and down to and from brain to peripheral tissue . Spinal cord is covered by three tissue layer known as Indian arrowroot , arachnoid membrane and dura mater . The blank between pia and arachnid mater is filled with fluid bonk as cerebrospinal fluid . The space outside dura mater is known as epidural space . Spinal cord tumor in neck is divide into three type depend on location where the neoplasm is situated within spinal cord in neck opening .
Types of Spinal Cord Tumor of Neck (Cervical)
The non - aggressive spinal cord tumor in cervix is known as benignant cervical tumour and belligerent neoplasm is known as malignant spinal electric cord tumour . Most of the spinal cord tumor in neck are non - belligerent benign tumor and often diagnosed in previous stages when tumour is severely squeeze the spinal electric cord .
type of spinal cord tumor in neck :
Intra-medullary Spinal Cord Tumor of Neck
Intramedullary spinal cord tumor of neck opening is most often a benignant tumor . Tumor mostly develop from nerve cell ( neuron ) within spinal corduroy and seldom from nerve fibers . The most common tumour arising from nerve cells in neck opening are Astrocytomas and Ependymomas .
Extra-medullary Spinal Cord Tumor of Neck
supererogatory - medullary spinal cord tumour begins to originate around the spinal cord and eventually do compression of the spinal cord . Most of the extra - medullary spinal electric cord tumor originates from arachnoid tissue layer and have intercourse as meningioma . Few epidural spinal tumors originate from dorsal ganglion nervus cellular telephone , which is located at the base of spinal nerve . Non - malignant benign extra - medullary spinal electric cord tumour grow easy in size of it and induce concretion of the spinal cord . The aggressive malignant extra - medullary spinal cord tumor of cervix may penetrate into spinal cord and cause severe destruction of nerve cells and nerve fibers .
Extra-dural Spinal Cord Tumor of Neck
epidural spinal tumors are most common spinal cord tumour of neck . Extradural tumor start outside dura mater in epidural space . The leaning of neoplasm includes Lipoma , Neuroma , Osteoma and Osteosarcoma . Most of the superfluous - dural tumor are malignant bone tumor and bond to vertebral column . The epidural benign spinal cord tumor in neck also originate from cheek fiber , extradural fatty tissue paper and surrounding bone . The rapid growth of malignant tumour often results in rapid symptoms triggered by compression of spinal cord as well as percolation of malignant neoplastic disease prison cell within spinal cord . additional dural non - malignant spinal electric cord neoplasm in neck opening induce meek to temperate condensation of spinal cord and afterward when symptoms are discount may form substantial turgid heap resulting in dangerous compression of spinal cord in cervix . The malignant supernumerary - medullary tumor often grows very rapidly in size and causes rapid percolation of spinal cord result in severe terms of nerve character and mettle cell result in quadriplegia .
Symptoms and Signs Caused by Spinal Cord Tumor in Neck
Spinal cord tumor in cervix causes symptoms by irritation or destruction of centripetal and motor spunk roughage as well as spunk cells . Initial symptoms are due to irritation of sensational and motor cheek fibers within the spinal cord . Irritation of sensory nerve fibers causes pain and indifference as well as irritation of motor nervus fibers stimulate weakness in one or all of the four extremity .
symptom because of spinal cord tumour are as follows-
Acute and Chronic Pain-
Initial acute pain lasts for 3 to 6 months . Pain lasting more than 6 month is known as chronic pain . Acute pain is due to initial irritation of pain fibers turn up within spinal cord in neck . infliction may be observed in neck , upper extremity , chest wall , abdomen or lower extremity depend on the excitation of specific sensory nerve fibers place with spinal cord . Severe pain may spread in multiple anatomical structures of the organic structure when the neoplasm consistently uprise in size resulting in austere spinal cord compression . Severe pain is also follow in multiple anatomical surface area when infiltration of neoplasm cell is wide spread within the spinal cord
botheration is often stern and continuous . Pain is false for arthritis and brawn pain since cause of origination of pain is often unknown . The radiological studies are execute only when pain become severe and does not reply to infliction medicinal drug . likewise advanced radiological study are necessary when annoyance symptom is associated with numbness and impuissance . The MRI and CT scan are the specific radiological report , which assist to achieve diagnosis of spinal cord tumour . Pain vividness increases in lying position or during nighttime . Pain is also increase with activities .
Symptoms of Tingling and Numbness Caused Due to Spinal Cord Tumor in Neck-
Tingling is the initial abnormal sensory symptom often assort with painfulness . In few slip of initial compression of spinal cord by tumor mass in cervix , the only symptom observed is episodic infrequent tingling . prickling may precede or deliver the goods the symptom of pain . In few cases prickle may be first isolated symptom . If treatment is delayed then further receptive nervus damage get serious pain and numbness . mien of spiritlessness suggests the sensory boldness is plausibly for good destructed and impairment is irreversible unless pressure over spinal electric cord is removed . Numbness is two-sided if insistency is removed within few days of keep symptom .
Symptoms of Weakness in Extremities Caused Due to Spinal Cord Tumor in Neck
Symptoms such as weaknesses are make by several medical condition . Weakness in absence of sensational symptoms like pain , tingling and indifference is often investigated for electrolyte or nutritional abnormality . Few cases of weakness are also treated for depression and anxiousness . The compression or percolation by a spinal cord tumor in cervix seldom involves only motor cheek . The isolated symptom of weakness may involve one or two extremities on one side and seldom all four member . In most of the cases in people suffering with spinal electric cord tumor of cervix , weakness follows symptom of painful sensation , tingling and spiritlessness . impuissance is often associated with pain and tingling . If charge such as weakness in presence of indifference is snub then patient suffering with large spinal corduroy tumor mass in neck may become quadriplegic within few weeks . Spread of weakness depend on death of sheaf of nerves , which provides motor face supply to pectus , stomach or extremities . wicked concretion of spinal cord on one side often have severe helplessness simultaneously circularize over chest , abdomen and extremities .
Symptoms of Frequent Fall Caused Due to Spinal Cord Tumor in Neck-
Patient during initial phase of spinal corduroy tumour increase in neck often gives a medical history of frequent fall and difficulties to get in and out of chair . History of frequent fall and mien of serious pain in extremity with or without spiritlessness is often diagnosed as joint arthritis of peg . chronicle of hurting , tingling and descend is a warning sign of possible disease necessitate spinal cord and contiguous MRI or CT Scan should be requested to rule out spinal electric cord tumor . In few cases patient may not give history of fall but may give history of difficultness to get in and out of bed as well as ineffectual to stand from sit down place without livelihood .
Symptoms of Paralysis (Paraplegia and Quadriplegia) Caused due to Spinal Cord Tumor in Neck
The destruction of motor fibers because of compressing of spinal electric cord by spinal neoplasm in neck results in severe malfunction of motor mettle . The whim from brain and subcortical gist when stops passing through motor spunk to the peripheral muscles then muscles do not run and becomes unable to contract or relax . Such a failure of social occasion of muscles resulting in nonstarter to contract or relax causes severe weakness . grave muscle helplessness in intact arm and leg results in paraplegia or quadriplegia . Paraplegia is a condition when two extremities are paralyzed and quadriplegia when four extremities are paralyzed . Paraplegia and quadriplegia condition develops when integral bundle of motor mettle is damaged by compression or infiltration by spinal cord tumour mass in neck . Paraplegia and quadriplegia develops when initial symptom of pain in the ass , tingling , spiritlessness and weakness are either discount or diagnose as a due to unlike disease than spinal cord tumor of cervix .
Symptoms of Incontinence Caused due to Spinal Cord Tumor in Neck
The parasympathetic spunk fibers of urinary vesica , sigmoid colon and anus are bundled within spinal cord . These bundle of parasympathetic nerves travel up and down within spinal cord . The parasympathetic spunk branches out from spinal cord and passes to urinary vesica , sigmoid colon , urethra and anus as a third and forth sacral nervus . stern compression or percolation by spinal tumor mass in neck causes lasting or temporary damage of these parasympathetic nerves . The symptoms that follow are incontinence of urine and potty .
Investigations and Diagnosis of Spinal Cord Tumor in Neck
The reliable sketch for diagnosis of spinal cord tumor of neck opening is CT Scan and MRI survey of the vertebral column and spinal corduroy .
Blood , urine and faeces examination in most of the cases is normal . In late stages during sedentary life style because of severe weaknesses and being unable to move , the blood electrolyte often turns abnormal . In few cases of sedentary patient , lineage examination may suggest low haemoglobin and red descent cell count causing anemia .
X - Ray Chest - Chest X - Ray is routinely performed in most of the cases who are kick of breast pain and weakness . Chest botheration may be because of irritation of sensory nerve by spinal cord tumor of neck opening . Chest X - electron beam if showing positive signs of neoplasm mass in patient complaining of pectus annoyance then elaborated chronicle of painful sensation is essential to dominate out metastasis ( spread of tumor ) to neck spinal cord . Urgent MRI and CT Scan are advocate if chest of drawers X - Ray of patient suffering with pain , tingle , numbness or failing show cancer growth in lung . MRI and CT Scan of total vertebral pillar and spinal cord are indicated to rule out metastasis of primary tumor into spinal cord .
X - Ray Neck Vertebral Column - cristal - Ray of spinal cord and vertebral column in cervix may not differentiate the tumor mountain if the tumor mass is benignant . The X - Ray does show irregularities of os when malignant tumor is attached to bones of vertebral column of neck opening .
CT Scan of Neck Vertebral Column and Spinal Cord – Neck CT Scan will speciate the tumor mass in neck from normal anatomical structure . CT scan may not show detail of tumor percolation into tissue paper of spinal cord but will show the severeness contraction of spinal corduroy . CT scan also shows the details of epidural malignant tumor , which originates from bones of vertebral column .
CT Scan of Lung, Brain and Abdomen
CT scan of lung , brain and abdomen is recommend once neck spinal electric cord tumour mass is diagnosed by MRI or CT scan . The primary malignant tumor of lung , brain and colon may metastasise to spinal cord of neck opening .
MRI of Neck Vertebral Column and Spinal Cord-
MRI ( Magnetic Resonance Image ) study gives good information point of abnormalities associated with soft tissue paper like spinal cord , ligament and tendons . While CT scan provides good info of bones and cartilages . The spinal cord compression and percolation of spinal electric cord tumor of neck is evaluated with MRI for detailed information . The decision to perform surgery depends on adherence or infiltration of tumour in to spinal cord and MRI render selective information of tumor behavior .
Tumor Biopsy
Once the spinal cord neoplasm is diagnosed with CT scan and MRI then the tumour biopsy is performed to judge the tumor deportment . Biopsy will differentiate benign and malignant character of the tumor . The theatrical production categorization of spinal corduroy tumor mass is assessed following detailed pathological study of biopsy samples . Staging is necessary to classify benignant and malignant spinal corduroy tumor of neck .
Treatment of Spinal Cord Tumor of Neck
The choice of discourse for spinal electric cord neoplasm of the neck is conservative treatment , chemotherapy and surgical treatment . The non - belligerent benign tumour is plow with buttoned-down treatment and chemotherapy . The belligerent benign and malignant tumour is do by with surgery followed by chemotherapy .
Most of the spinal electric cord tumour of neck is treated with surgical process . Outcome and keep an eye on up results are better if tumor hatful is surgically transfer .
extirpation of Spinal Cord Tumor in Neck - little isolated spinal corduroy tumor of neck is surgically absent . Removal of small tumor during early point is harmless and post - surgical complications are often none . great spinal electric cord tumour is often closely adhered to spinal cord and cause severe press over spinal cord . Such orotund spinal cord tumor mass is difficult to remove without cause surgical psychic trauma to spinal cord . In many example tumor mass is partially removed and residual tumor is do by with chemotherapy . The malignant aggressive tumor is seldom plow with operation . In few cases alleviative operating theatre is performed for symptomatic pain alleviation and improve symptoms like numbness and weakness . Such operating theatre is sleep with as lenitive surgery . Sometime palliative surgery is perform to forbid quadriplegia or paraplegia . declamatory tumour mass in few cases is withdraw after embolization of blood vessels .
Embolization of Spinal Cord Tumor in Neck - Embolization of blood vessels is execute to pass line of descent supplying to tumor mass , so tumour volume will not grow and possibly shrink . A lowly catheter is passed into several arteries add blood to tumor mass . Through the catheter , which is set in arteries or arteriole ( small arterial blood vessel ) several tiny helix are introduce and placed within the lumen of these arteries . Coil initiate blood coagulum and eventually origin coagulum blocks the arterial blood menses to the neoplasm wad . Lack of rip supply helps to prevent ontogeny and finally causes shrinking of the tumor mass . ulterior operation is perform to scratch the tumor , which is small in size . The surgery helps to remove the contraction of spinal corduroy and helps to relieve symptom . cut could be fond or complete depending on tumour adhesion or percolation into spinal cord .
Chemotherapy for Spinal Cord Tumor of Neck
Large neoplasm mass of spinal corduroy located in neck are often treated with chemotherapy so as to shrink the tumor mass . The smaller tumor mass may be easier to dissect from normal tissue paper prior to ablation . Few belligerent malignant tumour and large benign tumor are partly excised since most of the neoplasm is either adhered to spinal corduroy or infiltrated in spinal corduroy . The remaining neoplasm is treated with chemotherapy .
Life Expectancy, Outcome and Prognosis of Spinal Cord Tumor of Neck
The medical prognosis depends on symptomatic easing . issue is favourable depending on former diagnosing and when spinal cord neoplasm mass in neck is small resulting in long life sentence anticipation . natural selection charge per unit of patient with spinal cord tumor of neck is higher leave in longer life expectancy when neoplasm mass is little and operable . Small benignant tumour mass is often completely withdraw and recurrence is rare . The animation anticipation and survival charge per unit following operative treatment result in everlasting remotion of spinal cord tumor of neck is excellent . Patient may expect a prolonged normal life-time anticipation unless patient is suffering from any other serious illnesses . The prospect is also excellent in such slip after removal of the tumor . The symptomatic pain stand-in and improvement in numbness as well as weakness is acceptable when most of the enceinte benign tumour is surgically removed .
The upshot and prognosis is worst in spitefulness of surgical treatment and chemotherapy when magnanimous neoplasm mass has infiltrate into spinal cord or causes austere compression of spinal corduroy . Life expectancy in such causa is less than 5 years and survival charge per unit is very low beyond 5 year . Prognosis is also not satisfactory with malignant spinal corduroy tumor of neck when tumor mass is pack together the spinal cord and possibly infiltrated in spinal cord . aliveness anticipation is often less than few calendar month when expectant tumor deal is aggressive and malignant . Survival rate in such lawsuit is very low often counted in weeks or months .
