Primary tumors of the axial spine

Primary tumors of the spinal column include a variety of pathologies with variable symptoms, outcomes, and treatment. Knowledge of the lesion's pathology is necessary for proper treatment of any patient presenting with a mass in the bony spinal column. Malignant tumors, such as chordomas, plasmacytomas, osteosarcomas and chondrosarcomas require aggressive surgical resection if the goal is curative intent. Adjuvant chemotherapy and radiation may be needed if the margins of the lesion are compromised, and patients should be followed for several years to monitor for tumor recurrence. In contrast , tumors of benign pathology, such as giant cell tumors and aneurismal bone cysts, may present in younger patients. In all patients, pain is the most common symptom. This chapter will review the symptoms, diagnosis and treatment for primary spinal column tumors, with a focus on the current treatment strategies to optimize patient outcomes.