Spinal Tumours — How Diagnosis and Treatment Work in Poland

Spinal tumours account for a small fraction of all cancers, but their location makes diagnosis and treatment particularly demanding. The proximity of the spinal cord, nerve roots and major blood vessels means every therapeutic decision must be carefully weighed.

In 2023, six Polish medical societies — including the Polish Society of Spine Surgery, the Polish Society of Oncology and the Polish Society of Neurosurgeons — published joint recommendations on the management of spinal tumours. It is the first comprehensive document of its kind in Poland, covering the full spectrum of issues: from imaging diagnostics and biopsy to surgical treatment, chemotherapy and radiotherapy.

Why These Recommendations Matter for Patients

In practice, a patient with a spinal tumour sees multiple specialists — a neurosurgeon, an oncologist, a radiation therapist. The challenge is that experts in this field are spread across the country. Molecular histological diagnostics may be available in one centre, oncologic spine surgery in another, and proton beam therapy in yet another. The recommendations create a shared language and a clear care pathway so the patient does not get lost between institutions.

The panel developed 89 evidence-graded recommendations (levels A, B and C) following the North American Spine Society classification. In addition, a national network of experts was established — a directory of centres and specialists competent in treating rare spinal tumours such as sarcomas and chordomas.

When to Suspect a Spinal Tumour

Most back pain has musculoskeletal causes and does not require oncologic workup. However, certain symptoms should raise a red flag: pain that worsens at night or at rest, pain unresponsive to standard treatment, progressive limb weakness, sensory disturbances or sudden bladder control problems.

In these situations the recommendations call for urgent imaging — MRI is the first-choice study. If a primary tumour is suspected, a correctly performed biopsy is critical, ideally at the centre that will go on to deliver treatment.

Metastatic vs. Primary Tumours

It is worth knowing that most spinal tumours are metastases from cancers in other organs — lungs, breast, prostate, kidneys. Treatment of spinal metastases focuses on pain control, mechanical stabilisation and preservation of neurological function. The decision to operate is made by a multidisciplinary team.

Primary spinal tumours — sarcomas, chordomas, osteosarcomas — are far rarer but demand a more aggressive, coordinated approach. This is precisely where the expert network plays a key role: the patient should reach a centre with experience in these types of operations.

What This Means at Allenort

At Allenort Spine & Brain, a multidisciplinary approach is standard — neurosurgeon, physiotherapist and psychologist collaborate at every stage of treatment. When a neoplastic process is suspected, our team carries out the initial workup and refers the patient to the appropriate oncology centre while maintaining continuity of care.

If you have back pain that does not respond to typical treatment, gets worse at night or is accompanied by neurological symptoms — do not delay a consultation. Early diagnosis makes a significant difference.

Source: Recommendations of the Polish Society of Spine Surgery et al. European Spine Journal, 32, 1300–1325 (2023). DOI: 10.1007/s00586-023-07546-2