Primary Spine Cancer and Benign Spine Tumors

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Duke's spine and cancer experts work together to find the best strategy to treat your spine tumor. We treat the full range of cancers that originate in the bony spine itself (including chordomas and sarcomas), the spinal cord (including astrocytomas and ependymomas), as well as benign spinal column and spinal cord tumors (including schwannomas, meningiomas, and hemangiomas).

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Expert Spine Cancer and Tumor Care

Although most cases of spine cancer are metastatic (meaning they have spread from another part of the body already affected by cancer), our specialists are also experts in the rare forms of spine cancer and tumors that are primary (meaning they originate in the spine or spinal cord). 

We base our treatment recommendations on input from our spine and cancer specialists, who develop a personalized treatment plan for each person. As a team, we recommend the best course of action for you. It may include radiation, chemotherapy, radiosurgery, traditional surgery, or a combination of these therapies.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.


To determine whether you have spine cancer or a benign spine tumor, your doctor will perform a physical exam. You may also need the following tests:

Minimally Invasive Biopsy

A tissue sample from your tumor is extracted and tested for cancer. An imaging technique, such as X-ray or CT scan, helps guide the doctor during the minimally invasive procedure.


X-rays take pictures of bones inside your body and show any areas of instability in your spine. Because X-rays only show bones and not discs or nerves, an additional imaging test is usually needed.


Magnets and radio waves are used to take detailed pictures of the bones in the spine, the spinal discs, the nerve roots, and the spinal cord. 

CT Scan

A series of cross-sectional pictures produce detailed, 3D images of your spine and spinal cord.

CT Myelogram

A dye is injected into the sac around the nerve roots in your spinal cord; this makes them more visible on a CT scan.

Bone Scan

A radioactive tracer is injected into a vein to help doctors identify signs of cancer in your bones. A special camera that detects radiation takes pictures of your spine to show how much of the tracer has collected in your bones.

PET Scan

A radioactive tracer collects in organs and tissues, making them more visible in images. A scanner takes 3D pictures of your spine that highlight the location of tumors.


Treatment depends on your tumor type, where it is located, and your symptoms. With certain types of small tumors, we may recommend a watch-and-wait approach. For benign tumors, surgical removal of the tumor is usually the only treatment needed. In many other cases, we recommend a combination of treatments.

Tumor Removal Surgery

Surgically removing your spinal tumor is usually the best course of treatment. We are experts at successfully extracting the delicate lesions on your spinal column or spinal cord. With intraoperative CT or MRI guidance, your surgeons can see real-time images of your spine during surgery, which help them be as precise as possible. For chordoma and sarcomas, we strive to remove the tumor in one piece. Removing as much of the tumor as possible -- and keeping it intact -- is key for optimal results as it increases your chances of long-term remission.

Spinal Cord Decompression and Stabilization

This surgery removes the tumor or the section of the spine that is pushing on the spinal cord or nerve roots. Because this can leave the spine unstable, bone grafts and/or metallic implants may be inserted to restore spinal stability.


These minimally invasive procedures treat spinal compression fractures that can be caused by tumors and, if left untreated, can cause pain or a deformed spine (kyphosis). Surgeons use a balloon to increase distance between the vertebra and inject a cement-like substance into the fractured bone to keep it in place.

Radiation Therapy

Radiation therapy is an effective treatment for some spinal cord and spinal column tumors. High-energy beams target the tumor to kill or slow the growth of cancer cells. For certain tumor types, such as chordoma, we may recommend radiation therapy before or after tumor removal surgery to minimize the chances of recurrence.


Chemotherapy, given orally or by infusion into a vein, may be prescribed to kill cancer cells after surgery and/or radiation therapy.

Spinal Radiosurgery

This outpatient procedure targets radiation beams directly on your spinal tumor to reduce its size and lessen the pain it may cause. Because it is a minimally invasive procedure, radiosurgery can be a quick and painless option for some spine tumors. 

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Why Choose Duke

Surgical Expertise
Our spine surgery team has the experience and precision needed to remove delicate spinal cord and spinal column tumors. We perform more than 3,000 spine surgeries every year. Our program combines the expertise of specialists in both spine and cancer care. As a National Cancer Institute Comprehensive Cancer Center, we provide a level of cancer expertise and experience only found in the top 4% of U.S. centers. We are also part of the National Comprehensive Cancer Network (NCCN), an alliance of the nation’s leading cancer centers dedicated to improving patient care.
Precise Diagnosis
Determining whether your spine tumor is cancerous requires pinpointing its exact location, type, and how advanced it is. We use advanced imaging tests and minimally invasive biopsy methods to get accurate, fast results so we can plan and start your treatment as soon as possible. 

Team Approach
Each expert on our team plays a key role in ensuring your spinal tumor shrinks or is removed. We take every precaution to reduce your risk of recurrence. Your care team includes surgeons, oncologists, and radiation specialists.

Intraoperative Imaging Technology
We offer advanced intraoperative capabilities with CT and MRI. That means our surgeons use detailed, real-time 3D pictures of your spine to guide them while they surgically remove your spinal tumor.

Support for You and Your Family
Our comprehensive cancer support services range from helping you minimize the side effects of cancer treatment to helping you and your family cope with the emotional and psychological effects of diagnosis and treatment. 

This page was medically reviewed on 11/01/2022 by