Common tumors involving the spinal vertebra:
(1) breast
(2) lung
(3) prostate
(4) thyroid
(5) kidney
(6) gastrointestinal tract
(7) multiple myeloma
(8) malignant non-Hodgkin's lymphoma
(9) Hodgkin's disease
Features that may suggest an underlying malignant process:
(1) age < 20 years, or > 50 years with no previous similar episodes of pain
(2) history of cancer
(3) constitutional symptoms (unexplained weight loss, night sweats, excessive fatigue, fever)
(4) pain that is worse in supine position
(5) pain that is worse at night
(6) pain that is constant, dull and not relieved by rest
(7) generalized bone pain or pain in multiple bones
(8) elevated ESR
(9) pain that is unrelated to movement or posture
where:
• An increase in the ESR, fever and night sweats may also be seen in infections and immune disorders.
Imaging studies (bone scans, CT scans, MRI) may help identify tumor foci.
