Bone cancer in the spine can stem from a tumor that first forms in bone tissue. Alternatively, it can be due to cancer from another part of the body that has spread to the spine.

The bones of the spine, called vertebrae, are the most common place for cancer to spread. It can cause persistent back pain and soreness.

Treatment may include surgery, radiation therapy, chemotherapy, or a combination. The treatment option that a healthcare professional will choose depends on if the spinal cord or nerves are at risk from vertebral bone metastasis.

Read on to learn about bone cancer in the spine, including the causes, types, symptoms, treatment, and more.

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Bone cancer in the spine can be primary or secondary.

Primary means that the cancer starts in the vertebrae. However, this is rare, affecting just 0.9 per 100,000 adults in the United States annually.

The causes of most primary bone cancers in the spine are unknown, but some may be due to exposure to cancer-causing agents. Additionally, some families have a higher incidence of spinal tumors, so genetics may play a role.

Secondary bone cancer starts as primary cancer in another part of the body but later spreads, or metastasizes, to the spinal column. Some primary cancers that metastasize to the spine include:

The following cancers may also spread to the spine:

Several types of cancerous bone tumors of the spine include the following:


Chordoma is a slow-growing spine cancer that affects one in 1 million individuals worldwide. It most often manifests either at the part of the spine near the tailbone, called the sacrum, or the part that joins the skull.


According to an older 2011 study, chondrosarcoma is the third most common primary bone cancer.

It most frequently appears in the thoracic spine, which involves the vertebrae in the chest. It also affects the cervical and lumbar spine in the neck and lower back regions.


Osteosarcoma of the spine is a rare but aggressive cancer. Older research from 2013 reports that it is the second most common primary bone tumor, but it affects the spine in just 3–5% of cases.

It most often appears in the sacrum, with the next common occurrence in the thoracic and lumbar spine.

Learn more about osteosarcoma.

Ewing sarcoma

While Ewing sarcoma accounts for 6–8% of bone cancers, it rarely involves the spine.

Most people with this cancer usually do not receive a diagnosis until it reaches an advanced stage. It is aggressive and tends to recur and metastasize.

Learn more about Ewing sarcoma.

The most frequent symptom that could indicate spinal bone cancer is back pain unrelated to an injury or physical activity. It may worsen with activity or when lying down at night. Pain may also spread beyond the back and affect the hips, legs, or arms.

Symptoms may also involve neurological problems that manifest as:

  • loss of bowel or bladder control
  • loss of sensation in the chest, arms, or legs
  • decreased sensitivity to pain, heat, and cold
  • tingling sensations
  • loss of sensation in the pelvis

Symptoms vary with the type of bone cancer present in the spinal column. For example:

  • Chordoma: A tumor at the base of the skull can cause double vision and headaches. In contrast, a tumor near the sacrum can cause pain that radiates down the legs as well as a loss of bowel and bladder control.
  • Chondrosarcoma: The most frequent symptom is pain. Other symptoms include a mass that a person can feel and neurological problems.
  • Osteosarcoma: The most common symptom is pain, but many people with this cancer have neurological symptoms.
  • Ewing sarcoma: The most frequent symptoms include limb weakness, pain, and a lack of bowel and bladder control.

Treating secondary tumors in the spine involves using mainly palliative strategies, which means the goal is reducing pain and helping a person feel more comfortable. This may include steroids to decrease swelling as well as radiation and surgery to shrink or remove tumors. People may also have chemotherapy.

Conversely, treating primary bone cancer in the spine includes surgery, radiation therapy, and chemotherapy. The following are the treatments for specific types of bone cancer:

  • Chordoma: Treatment consists of surgery, radiation therapy, or both.
  • Chondrosarcoma: The main treatment of choice for chondrosarcomas is surgery.
  • Osteosarcoma: A combination of surgical removal, radiation therapy, and chemotherapy is the treatment of choice.
  • Ewing’s sarcoma: The first-line treatment option is surgery, though other options may also include radiation therapy, chemotherapy, or both.

If a person experiences back pain or any new symptoms that do not disappear, they should talk with a doctor. This may result in timely diagnosis and treatment.

Surgical removal may be a cure if the cancer is a primary tumor in the early stage.

Primary bone cancer in the spine is rare, but the spine is a common location for bone metastasis of secondary cancers. Some cancers that metastasize to the spine include lung, prostate, and breast cancers.

Persistent back pain that does not stem from an injury or activity is the most common symptom. Treatments for primary bone cancer vary by type, but they may include surgery, radiation therapy, chemotherapy, or a combination.