On the first visit, if there were definite telltale evidence of spinal tumor, the best spine specialist would recommend x-rays as well as some basic blood investigations such as hemoglobin, erythrocyte sedimentation rate [ESR], CRP, serum calcium, phosphorus and alkaline phosphatase.
Based on these tests, or sometimes, in the presence of some very significant signs or symptoms, you may be asked to undergo MRI scanning. Plain x-rays demonstrate bony features; while MRI demonstrates the spinal cord, its nerve roots, the intervertebral disc between the two bones of the spine. Both these tests are complimentary in nature; doing one does not necessarily mean that the other one is not needed.
Based on individual cases, additional investigations may be ordered by the spine consultant including specialized blood investigations to identify involvement of other vital organs of the body, bone scan to identify the involvement of any other part of the bony skeleton, CT scan of the chest, ultrasound of the abdomen and biopsy of the waist bone. Ladies may need to undergo gynecological examination.