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Condition/Disorder Synonyms

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  • Intraspinal tumor

  • Spinal cord neoplasm

  • Spinal cord space-occupying lesion

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ICD-9-CM Codes

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  • 237.5 Neoplasm of uncertain behavior of brain and spinal cord

  • 238.0 Neoplasm of uncertain behavior of bone and articular cartilage

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ICD-10-CM Codes

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  • C72.0 Malignant neoplasm of spinal cord

  • D33.4 for benign neoplasm of spinal cord

  • D43.4 Neoplasm of uncertain behavior of spinal cord

  • D48.0 Neoplasm of uncertain behavior of bone and articular cartilage

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Preferred Practice Patterns1

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Key Features

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Description

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  • Cell growth in or around the spinal cord

  • Spinal tumors account for approximately 15% of primary CNS tumors

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Essentials of Diagnosis

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  • Primary spinal tumors are ones that start in spinal tissue.

  • Secondary spinal tumors are spread from other sites (metastasis).

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General Considerations

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  • Spinal tumors are divided into 2 groups.

    • Intramedullary (those that arise within the spinal cord tissue)

    • Extramedullary (those that arise within the spinal column but outside of the spinal cord, in the meninges)

  • Most common primary extramedullary tumors are neurofibromas and meningiomas.

  • Physical presentation is the result of the location and extent of the tumor (see paraplegia and tetra/quadriplegia).

  • Onset of signs/symptoms is gradual.

  • Clinical correlation

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Demographics

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  • Equal male and female incidence; can impact any age

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Clinical Findings

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Signs and Symptoms

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  • Back pain: usually worse with lying down or made worse by an extended time in a recumbent position

  • Stiffness of the back muscles

  • Vascular changes: cold sensation upper or lower extremity

  • Loss or alteration of sensation

  • Loss or alteration of motor function

  • Loss or alteration of bowel and bladder function

  • Urinary frequency

  • Urinary urgency

  • Sphincter disturbances

  • Syringomyelia-like symptoms

  • Brown-Séquard syndrome- like symptoms

  • Hydrocephalus

  • Increased intracranial pressure

  • Papilledema

  • Atrophy

  • Hyporeflexia

  • Spasticity

  • Hyperreflexia

  • Gait disturbances

  • Sexual dysfunction

  • Pain to palpation over the involved spinal segment in 50% of patients

  • Radicular pain

  • Paralysis

  • Tumors can affect

    • Spinal cord cells

    • Nerve root compression

    • Circulatory system

    • Bone strength

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Functional Implications

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  • Loss of independence with ADLs and self-care

  • Loss of independence with locomotion in home and community environments

  • Altered sensation predisposing patient to injury

  • Loss (or altered) ability to work and participate in leisure activity

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Possible Contributing Causes

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  • Unknown cause for primary spinal tumors

  • Spine and spinal cord are common metastatic sites for other forms of cancer including breast, bone, lung, lymphoma.

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Differential Diagnosis

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  • Leukemia

  • Lymphoma

  • Myeloma

  • Stenosis

  • Spondylitis

  • Muscle strain

  • Degenerative or protruding disc

  • Disease of the gall bladder

  • Disease of the ...

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