[Bone diseases with pain. Primary bone tumors of the spine]

Primary bone tumors of the spine and sacrum are unusual, both benign and malignant. A histological diagnosis must be obtained from biopsy specimen, after thorough imaging studies, using X-ray, CT (computed tomography), and MRI (magnetic resonance imaging). The treatment of both benign and malignant osseous spinal tumors is basically surgical. Simple curettage or resection is appropriate for the management of benign tumors. Although a curative wide resection is optimal for the malignant tumor, it is not unusual that only the marginal or intralesional resection is indicated because of the highly progressed stage of the tumor. In the last few years clinical data has been published demonstrating that proton radiation therapy offers an effective treatment option for sacral or skull base chordomas.