Spinal tumors account for about 6% to 10% of systemic bone tumors. Various types of bone tumors can almost be seen in the spine, such as osteosarcoma, osteoid osteoma, aneurysmal bone cyst, while metastatic bone tumors account for more than half of spinal tumors. What are the symptoms of spinal tumors? Clinical phenotype of spinal tumors Due to the lack of characteristic clinical manifestations in the early stage of spinal tumors, it is difficult to detect in the early stage and easy to be misdiagnosed and omitted. Most of the spinal tumor patients are often in the middle or late stage when they are diagnosed, which brings certain difficulties to the treatment and affects the therapeutic effect. Early and timely diagnosis and treatment of spinal tumor patients have a very important influence on their therapeutic effect and prognosis. Whether it is primary or metastatic spinal tumor, its typical clinical manifestations are local pain, neurological dysfunction, local mass or spinal deformity, etc. Asymptomatic spinal tumors usually have no symptoms. Asymptomatic spinal tumors are usually found during physical examination. Pain Pain is the most common and main symptom of spinal tumor patients. 80%~95% of primary spinal tumors are diagnosed with pain as the first symptom and sometimes the only symptom. The possible mechanisms of pain caused by spinal tumors include: infiltration and destruction of bone (especially swelling of periosteum), compression of bone lesion tissues, pathologic fracture, instability of spinal vertebral joints, compression and erosion of spinal cord, nerve root or plexus, etc. Depending on the nature of the tumor and the site of occurrence, the time and nature of the pain also differ. From the time of occurrence of pain, the pain can appear in months or years before the spinal tumor is diagnosed, in which the pain of benign spinal tumors generally has a longer course, which can be months or even years. Malignant spinal tumors, such as osteogenic sarcoma, Ewing’s sarcoma, or bone metastases, etc., have a relatively shorter history of pain, but if benign tumors compress the spinal cord or nerve roots at an early stage, the pain occurs in a relatively shorter period of time. Nocturnal pain is a characteristic manifestation of almost all spinal tumors and is equally common in patients with spinal tumors. The main reasons are: (1) At night, the patient usually adopts the lying position, the venous pressure is relatively high, and the peripheral nerves around the tumor are stimulated. (2) At night, the mental attention of patients with spinal tumors is relatively more concentrated, and they become more sensitive to pain. (3) Some inflammatory mediators released by the tumor form stimulation to the nerves. Coughing, sneezing, exertion or other actions that increase intra-abdominal pressure can induce pain aggravation. 2.Mass Because spinal bone tumor mostly occurs in the vertebral body, and the location of vertebral body is deeper, it is difficult to be found on the body surface, so it is not common for patients with mass as the first manifestation, mainly seen in the cervical vertebrae or tumors in the posterior spinal accessory structures. The mass of spinal malignant tumor grows faster and often forms compression to the surrounding tissues, so there are often local pain and discomfort. Metastatic spinal tumors are often found before the formation of larger masses due to the existence of primary lesions and the fact that metastatic tumors are generally more malignant and grow more rapidly, which can easily induce spinal pain and neurological symptoms. 3, Deformity: spinal deformity caused by spinal tumor is not uncommon, and its main mechanisms include: destruction of vertebral body and/or accessories by tumor; spasmodic reaction of spinal peripheral tissues and extrusion of surrounding structures by large tumor volume. For example, osteoid osteoma can often appear concave to the side of the lesion side of the lateral convex deformity, and the apex of its lateral curvature is mostly the site of the lesion. Neurological dysfunction: Spinal cord nerve compression can be caused by direct invasion of the tumor itself, or it can be caused by the deformity secondary to the destruction of bony structure by the tumor. Since spinal tumors are mainly located in the vertebral body, they tend to compress the pyramidal tract or anterior horn cells from the front, therefore, they often firstly manifest motor function damage, and their clinical symptoms vary depending on the degree and location of spinal nerve compression, such as anterior horn syndrome, posterior horn syndrome and hemisection syndrome of spinal cord. Systemic symptoms of spinal tumor Early spinal tumor patients’ systemic symptoms are not obvious, and systemic symptoms usually appear in the late stage of primary malignant tumors and metastatic tumors, and anemia, emaciation, low fever, fatigue and so on are malignant clinical manifestations.