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Tests and diagnosis
By Mayo Clinic staffSpinal tumors sometimes may be overlooked because they're not common and because their symptoms resemble those of more common conditions. For that reason, it's especially important that your doctor know your complete medical history and perform both general physical and neurological exams. If your doctor suspects a spinal tumor, one or more of the following tests can help confirm the diagnosis and pinpoint the tumor's location:
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Spinal magnetic resonance imaging (MRI). MRI uses a powerful magnet and radio waves to produce images of your spine. MRI accurately shows the spinal cord and nerves and yields better pictures of bone tumors than computerized tomography (CT) scans do. A contrast agent that helps to highlight certain tissues and structures may be injected into a vein in your hand or forearm during the test.
Some people may feel claustrophobic inside the MRI scanner or find the loud thumping sound it makes disturbing. But you're usually given earplugs to help with the noise, and some scanners are equipped with televisions or headphones. If you're very anxious, ask your doctor about a mild sedative to help calm you.
- Computerized tomography (CT). This test uses a narrow beam of radiation to produce detailed images of your spine. Sometimes it may be combined with an injected contrast dye to make abnormal changes in the spinal canal or spinal cord easier to see.
- Myelogram. In this test, a contrast dye is injected into your spinal column. The dye then circulates around your spinal cord and spinal nerves, making them easier to see on an X-ray or CT scan. Because the test poses more risks than does an MRI or conventional CT, a myelogram is usually not the first choice for diagnosis. However, it may be used to help identify compressed nerves and for those who can't have an MRI.
- Biopsy. The only way to determine whether a tumor is noncancerous or cancerous is to examine a small tissue sample (biopsy) under a microscope. If the tumor is cancerous, biopsy also helps determine the cancer's grade — information that helps determine treatment options. Grade 1 cancers are generally the least aggressive, and grade 4 cancers, the most aggressive. How the sample is obtained depends on your overall health and the location of the tumor. Your doctor may use a fine needle to withdraw a small amount of tissue, or the sample may be obtained during surgery.
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- Brain and spinal tumors: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/brainandspinaltumors/detail_brainandspinaltumors.htm#43233060. Accessed Aug. 28, 2011.
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- Sachdev S, et al. Stereotactic radiosurgery yields long-term control for benign intradural, extramedullary spinal tumors. Neurosurgery. 2011;69:533.
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