Lumbar Spinal Tumor Classification

1. By Anatomical Location

Spinal tumors are generally classified as:

Location	Description	Common Examples
Extradural	Outside the dura mater (often vertebral)	* Metastases (most common) * Vertebral hemangioma * Chordoma
Intradural Extramedullary	Inside dura but outside spinal cord	* Schwannoma * Meningioma * Myxopapillary ependymoma (cauda equina) * Neurofibroma
Intramedullary	Within the spinal cord (rare in lumbar due to absence of cord)	* Very rare in lumbar spine * Usually not present below conus medullaris

2. By Origin or Histology

Type	Description	Notes
Primary benign tumors	Arise from nerve roots or meninges	Schwannoma, meningioma, hemangioblastoma
Primary malignant tumors	Originate in spinal structures	Ependymoma (esp. myxopapillary in cauda equina), astrocytoma
Metastatic tumors	Most common spinal tumors overall	Breast, prostate, lung, kidney metastases
Tumors of nerve roots (cauda equina)	Affect lumbar nerve roots	Often cause radiculopathy, incontinence, weakness

📌 Special Case: Cauda Equina Tumors

Typically intradural extramedullary
Common histologies:
- Schwannoma
- Ependymoma
- Neurofibroma
Symptoms:
- Back pain
- Sciatica
- Saddle anesthesia
- Bowel/bladder dysfunction