Spinal Cord Tumors are usually benign in adults and malignant in children (less than 18 years old). The incidence of having a spinal cord tumor is very low but possible. Patients will most commonly present with a neurologic deficit of the lower extremities, either unilateral or bilateral.  In severe cases, patients will present with urinary retention for at least 12 hours or greater; this can also be associated with numbness in the groin area.

Most spinal cord tumors are respectable and, if benign, are only removed if they are causing symptoms. Benign tumors such as Schwannomas are removed if they are compressing a nerve or clearly growing in subsequent imaging studies. Most benign tumors are observed until they become symptomatic or clearly grow by serial imaging.

Removing a tumor can be difficult and depends on the location. The spinal cord ends at the level of L1-2 and then proceeds as nerve roots or the cauda equina to exit and the various levels below. Tumors above the level of L1-2 are in the spinal cord itself and carry significant risk when undergoing resection. Tumors below the level of L1-2 pose less risk since they are attached to a nerve root. Tumors attached to a nerve sometimes render that nerve non-functional, making removal easier, since it may be possible to sacrifice the nerve during resection.

A Spondylolisthesis at L5-S1 is called an “Isthmic” Spondylolisthesis and affects approximately 5 to 7% of the population. A Spondylolisthesis at L4-5 is a called a “Degenerative” Spondylolisthesis. Both types can be painful and present with back pain, leg pain or both.

If a patient develops a foot drop or other leg weakness, conservative care will be initiated but if the weakness persists, you may surgeon may need to strongly consider surgical decompression.