Spinal tumors can begin in and around the spine or spread from another location. There are many types of spinal tumors, which can be cancerous or noncancerous.

Spinal tumors develop when cells in or around the spine begin to grow irregularly. There are several types of spinal tumors, and doctors classify them on the basis of the location of their epicenter.

This article discusses primary and secondary spinal tumors and their locations.

It outlines types of noncancerous, or benign, tumors and cancerous, or malignant, tumors.

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The American Cancer Society defines primary spinal tumors as beginning in or around the spinal cord. They are fairly uncommon, and only 2 in 10 are malignant, or cancerous.

Secondary spinal tumors are cancerous and begin in another body part and spread to the spine. Doctors sometimes call them “metastatic spinal tumors.” They may develop from primary cancers, such as lung, breast, and prostate cancer.

According to a 2016 review of the scientific literature, around 97 in 100 spinal tumors are secondary.

Around 70 in 100 of these develop in the thoracic and thoracolumbar areas, which are the middle and upper sections of the spine. Roughly 20 in 100 develop in the lumbar spine and sacrum, the lower sections of the spine.

Doctors classify spinal tumors according to the location of their epicenter. Tumors can be the following:

  • Intradural-intramedullary: These develop within the spinal cord. According to a 2022 review, intramedullary tumors are the rarest form of spinal tumors, accounting for 2–5%.
  • Intradural-extramedullary: These develop within the dura but outside the spinal cord. The dura is a thick layer of protective tissue surrounding the spinal cord.
  • Extradural: These account for 6 in 10 of all spinal tumors and are the most common type. They develop outside the dura.

The following sections outline some types of benign spinal tumors.

Hemangioma

Hemangiomas are extradural tumors that form from blood vessel tissues. They commonly occur in the thoracic and lumbar spine.

Osteoid osteoma and osteoblastoma

Osteoid osteomas and osteoblastomas develop in the spinal cord. Osteoblastomas tend to be larger and can develop into cancer. Osteomas are usually smaller and may resolve without treatment.

Meningioma

Meningiomas are among the commonest forms of intradural-extramedullary spinal tumors. These tumors begin in the meningeal tissues, which include the dura and other protective tissues. Around 8 in 10 of these develop in the upper spine.

Neurofibroma

Neurofibromas are a type of tumor in the spinal sheaf. This protective layer of tissue allows electrical signals to transfer efficiently through the spine. They are the second most common type of intradural-extramedullary spinal tumor.

Schwannoma

Schwannomas are the most common type of spinal sheaf tumor. These grow from Schwann cells, which are a type of glial cell that help to keep neurons alive.

Myxopapillary ependymoma

Myxopapillary ependymomas are a type of slow-growing ependymoma that usually affect the lower spine.

Lipoma

Lipomas are noncancerous lumps of fat. They develop when fat cells overgrow and can sometimes enter the spinal cord. They can span between 1 and 3 vertebrae.

Hemangioblastoma

Hemangioblastomas are a nonglial kind of intramedullary tumor. They are a type of hemangioma that grows from blood vessels within the central nervous system (CNS). Hemangioblastomas rarely span more than 1 or 2 vertebrae. They commonly form cysts and are more likely to affect males.

The following sections outline some malignant types of spinal cord tumors.

Ependymoma

Ependymomas are one of the most common forms of intramedullary tumors. They are a kind of glioma, a tumor that develops in glial cells. Glial cells are not neurons but an essential CNS component. Gliomas make up around 8 in 10 intramedullary tumors.

Ependymomas develop in ependymal cells. They tend to grow slowly, centrally, and within the spinal cord. On average, ependymomas span 3–4 vertebrae.

Astrocytoma

Astrocytomas are another type of glioma. They begin in astrocytes. These are forms of glial cells, which have several functions, such as improving synapse formation. Astrocytomas span an average of 5–6 vertebrae. They can grow outside the spinal cord.

Chordoma

Chordomas are slow-growing tumors that can develop anywhere along the spinal column’s length.

Chondrosarcoma

Chondrosarcomas grow in the spinal column from cartilage cells surrounding bone. They commonly affect the thoracic spine.

Ewing sarcoma

Ewing sarcoma is an extradural cancer that usually affects children and young adults.

Osteosarcoma

Osteosarcoma is the second most common primary bone tumor but is fairly uncommon in the spine. It most often affects the thoracic and lumbar vertebrae but may occur in the sacrum in association with Paget’s disease.

Multiple myeloma

Multiple myeloma is an extradural cancer that affects the blood’s plasma cells. Cancerous cells can collect in the bone marrow and the hard, outer part of bones.

Lymphoma

Lymphomas rarely originate in the spine but can metastasize from other areas. The most common subtype affecting the spine is diffuse large B-cell lymphoma, a type of non-Hodgkin lymphoma.

Doctors classify spinal tumors in several ways. Primary spinal tumors originate in the spine, and secondary spinal tumors originate elsewhere and spread to the spine. Spinal tumors can be benign or malignant.

Intramedullary tumors develop within the spinal cord, whereas intradural-extramedullary tumors begin in the layers that protect the spinal cord. Extradural tumors occur in the protective tissue surrounding the spinal cord.

Spinal tumors can develop anywhere on the spine, although they are most common in the upper and middle sections.