MRI Spinal Metastases

Spinal metastases are cancerous tumors that have spread to the spine from another part of the body. This spread of cancer cells is known as metastasis. The spine is a common site for metastases because the vertebral column’s venous system, known as Batson’s plexus, provides an easy pathway for cancer cells to travel from other parts of the body.

Causes

The primary cause of spinal metastases is the presence of a primary cancer elsewhere in the body that has the capability to spread. Common cancers that may lead to spinal metastases include:

• Breast cancer
• Prostate cancer
• Lung cancer
• Kidney cancer
• Thyroid cancer

Symptoms

Symptoms of spinal metastases can vary depending on the location and size of the tumors, but typically include:

• Pain in the back or neck, which may be worse at night or upon waking
• Numbness or weakness, often in the limbs, depending on where the spine is affected
• Difficulty walking or loss of function of the limbs due to nerve compression
• Loss of bladder or bowel control in severe cases
• Paralysis: Severe cases can lead to loss of motor function.
• Pathological fractures: Weakened bones can lead to fractures even with minimal trauma.

Diagnosis

Diagnosis involves a combination of clinical evaluation and imaging studies:

• Medical history and physical examination: Assessment of symptoms and neurological function.
• Imaging studies:
  • X-rays: Initial evaluation but may not detect early metastases.
  • MRI (Magnetic Resonance Imaging): The preferred method for detailed images of spinal cord and surrounding tissues.
  • CT (Computed Tomography) scans: Useful for assessing bone involvement.
  • Bone scans: Detects areas of increased bone activity.
• Biopsy: To confirm the type of cancer, if the primary source is unknown.

Treatment

Treatment aims to relieve symptoms, preserve neurological function, and stabilize the spine. It often involves a multidisciplinary approach:

• Radiation therapy: Commonly used to shrink tumors and relieve pain.
• Surgery: May be necessary to remove the tumor, stabilize the spine, or decompress the spinal cord.
• Medications:
  • Pain relievers: To manage pain.
  • Steroids: To reduce inflammation and swelling around the spinal cord.
  • Bisphosphonates: To strengthen bones and reduce fracture risk.
• Chemotherapy: Systemic treatment to target cancer cells throughout the body.
• Targeted therapy and immunotherapy: Depending on the type of primary cancer and its specific characteristics.