Pain is the main symptom of spinal neoplasms.
It is a vertebral pain or rachiodynia: it is a dull, deep pain with antalgic contracture of the para-vertebral muscles. It may be associated with nerve root pain (corresponding to the affected sensory nerve) more common in intradural extramedullary tumors.
The patient will feel a sense of heaviness or weakness in one or more limbs.
Motor disorders may be due to damage to the structures that control the motor function. There may be damage to:
motor nerve roots (flaccid paralysis)
anterior horn cells of the spinal cord (flaccid paralysis)
cortical-spinal tracts (spastic paralysis)
The propagation of motors deficiencies is characteristic and indicative of the type of spinal tumor. In fact, in the cross-pyramidal section, the nerves that control the lower limbs are placed laterally, while the more internal fibers innervate the upper limbs. This means that intramedullary tumors will provoke a descending motor deficiency (initial impairment of central fibers and then of the lateral ones), while extramedullary tumors will have an ascending symptomatology.
The speed with which symptoms occur varies according to the type of tumor. Obviously, they will arise faster in the case of malignant neoplasms and intramedullary tumors (which grow in a very narrow space, and therefore quickly communicate their presence and every variation in size).
Characteristics are paresthesia, which provokes a tingling “pins and needles” effect, numbness, or a hot / cold feeling.
Also in this case, as for the motor disorders, these sensations will have an ascending progression in extramedullary tumors and descending in the case of intramedullary neoplasms.
The hypo-anesthesia (patients report a sense of dead skin, a sensation of losing part or all of a limb) may have different distributions. Also in this case, it presents an ascending distribution in extramedullary tumors and descending with intramedullary tumors.
Sexual and Sphincter dysfunctions
They occur at a later age, and they are a characteristic of conus medullaris tumors (the terminal part of the spinal cord between the (XI) thoracic vertebra and the (I) lumbar).