Cervical Spine Conditions, TUMORS - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes miscellaneous tumors of the cervical spine.
Hemangioma:
•Hemangiomas are benign hamartomatous vascular lesions in the spine.
•Most hemangiomas are isolated lesions that affect a single vertebra.
•On x-ray, hemangiomas appear as abnormal thickened trabeculae with vertical striation (honeycomb appearance).
•Most are asymptomatic and present as incidental finding and do not require intervention.
•Preoperative embolization if resection is needed.
Osteoid osteoma and osteoblastoma:
•Osteoid osteoma and osteoblastoma are histologically similar to each other, however the osteoblastoma tends to grow larger than 2 cm.
•Osteoblastoma may sometimes displace characteristics that may be confused with osteosarcoma.
•Osteoblastoma – you will do marginal excision.
•Osteoid osteoma is almost impossible to visualize onx-ray due to its small size.
•The patient usually presents painful scoliosis or torticollis (pain is relieved with aspirin).
Aneurysmal bone cyst:
•Fluid level
oPain could be present
oTreatment is excision
•Expansile osteolytic lesion with a thin wall containing blood-filled cystic cavities that usually effect the posterior element of the spine.
Eosinophilic Granuloma
•Caused by histiocytosis X
•Usually seen in children under the age of 10 years old.
•It is a lytic lesion of the vertebral body that will show on x-ray as a dense ring of collapsed cortical bone sandwiched between intact vertebral discs (vertebral plana).
•It is rarely symptomatic and self-limiting.
•Conservative treatment with orthosis.
•Large tumor may compress the spinal cord and is usually treated by low dose radiation therapy.
Giant Cell Tumor
•It usually occurs in the sacral region of the spine and less commonly affects the cervical spine.
•It may be difficult to distinguish giant cell tumors from other tumors of the spine on x-rays.
•This tumor is usually found in the anterior column of the spine.
•On x-ray it will appear as a radiolucent expansile lesion with a cortical shell and a bony septa.
•Recurrence is common secondary to inadequate resection.
•10% incidence of malignant transformation due to irradiation.
Osteochondroma
•It is a cartilaginous growth on the surface of the bone.
•It usually arises from the posterior element (eg spinous processes).
•It may not be visible on x-rays.
•The radiolucent cap may grow and cause compressive symptoms.
•Excision if symptomatic.
•Malignant transformation to chondrosarcoma should be suspected if the cartilaginous cap is more than 2 cm in diameter.
Paget’s disease
•Paget’s disease is a chronic disorder that can result in enlarged bones.
•Excessive breakdown and formation of bone tissue which ends by sclerosis giving the ivory appearance on x-ray.
•Less likely to develop in the cervical spine and more common in the sacral and lumbar regions.
•Differential diagnosis for prostatic metastasis.
Osteosarcoma
•Osteosarcoma is rare in the spine.
•Malignant tumor is found to affect any level of the spine, although the lumbar and sacral regions are more common.
•On plane x-ray, osteosarcoma appears as lytic and blastic lesions with destruction of the vertebra and relative sparing of the adjacent discs.
Ewing’s Sarcoma
•It affects the body of the vertebra.
•Most commonly detected in patients between 10-20 years of age.
•Appears on x-rays as a lytic lesion with osseous expansion or sclerosis.
Multiple Myeloma
•It is the most common primary malignancy of the bones and spine.
•It is due to malignancy of the plasma cells.
•Appears on x-rays as lytic lesions of the bone (punched out lesions).
•Skeletal survey is used to screen for other lesions throughout the body.
•Bone scans have low sensitivity in detecting disseminated disease.
•Treatment is usually radiotherapy. Surgery is used for decompression and/or stabilization.
Lymphoma
•Mainly Non-Hodgkin’s lymphoma.
•Bone lymphoma is commonly diagnosed between 40-60 years of age.
•It can be detected on plane x-rays in only 30-42% of patients.
•Treatment is radiotherapy and chemotherapy.
Metastasis
•The most common tumor that metastasis in the spine are:
oProstate neoplasm
oBreast neoplasm
oLung neoplasm
oRenal neoplasm
oThyroid tumor
•Differential diagnosis – infection
oInfection usually affects the end plates
oTumor usually affects the body and the pedicles.

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[lawrencesusanno]

I just had an MRI 2 days ago with in minutes of meeting my new spinal doctor he wanted an emergency MRI but all the MRI centers closed at 5 pm, I got out of his exame room at 5:30pm, but but 8:15 am following the next morning they had an emergency MRI appointment set up for 7:15 pm, they were doing my neck area I'll get the results on Tuesday morning and the doctor will continue more MRIS to find where my spinal core is being compressed, I'm in shock since my spinal doctor asked about my bowel and bladder functions, I've had inconstant for over 7: yes, I've been der pressed having to wear pull ups and pads because of my honorable, soooo imbarresing!!!! mad, I've also had to endure severe pain, having to being methadone and that wood cause my heart to not funtion right, so I've been detoxing of the methadone, but asked my PCP doctor we need to talk about pain meds I will need after I'm of the methadone, I'm sick of being fatigued, no strength, just a walk around my block I barely make it back home almost falling on my face, always tripping, lately dizzy spells if I stand in one place almost falling back wards dropping things but the worst of all my symptoms, is the fact is I've been alone not being happy with a man by my side for stress relief, pain relief, with massage's, just to be held in his arms at night and feel excepted and cared for, 12'yrs no one by my side sick of being GOD PLEASE FIND A SOCTOR WHO WILL LISTEN TO ME, AND TRY TO FIX A PROBLEM IVE HAD SINCE I WAS PREGNANT, THAT WAS 34 YEARS AGO, YES HOLLY S@#$_--++!:'*, ILL PRAY THEY TELL ME THE TRUTH! SO MANY DOCTORS LIEING TO ME, SICK OF GID BLESS ANYONE WHOS IN THE SAME SITUATIONS, . STAY SAFE GOD BLESS

[joelewis]

Thank you for your thorough coverage of multiple issues which can or could be pronounced in the human back if certain symptoms occur & patient complaints & changes affected by central nervous system overload & a confused body regulatory system better know as what body

[ahmedalsayyad]

GREAT GREAT GREAT Jop SIR
please we need more oncology materials sir.

[questioneverything]

? I had a motorcycle accident, approximately 10 years ago. The hospital never performed a CT scan or an MRI at the time of the accident and they said patient kept falling asleep during triage. Then under behavioral status is set awake which means it's either one or the other so that's messed up. I find out 8 years later I had an MRI on my neck and I didn't even know it because my memory is really gone. I find out that I'm having a G generation of my C5 and C6 my C7. I have a hemangioma on my C7 which according to online is incredibly rare and it also says paranasal sinus disease. My doctor never told me about my C7 and should I be worried that this tumor could turn into something else or could be affecting me neurologically? I know it's not cancerous but a lot of places online said I can feed off of cancer someplace else in your body. I also suffer from celiac disease, dermatitis herpetiformis, COPD, across neck a broken right foot a couple sesamoids and now I guess this paranasal sinus disease which I can't breathe as it is. I'm fighting and I'm trying to figure it out but I don't understand why my doctor never told me about this it seems really serious and the C7 seems to be only about 1% or less people get it in that particular bone. It's sad all the nerve signals of the brain and the spinal cord tying together right in that bone and if there's a tumor in there this possibilities of some of the different brain sensories and blood vessels and everything are all mixed in together and not sending the correct neurological things that should be happening to my body. Things like forgetting time and not even remembering I ever had an MRI stuff like that. I don't really need a medical opinion just a thought process from somebody who thinks this might be serious or I don't have to worry about it or something that would put me at ease what should I do should I get a second opinion. Ty again . Bless up