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