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Dr. Paresh Bang
Consultant Spine Surgeon
Surgery for spine tumors In Betul
Surgery for spine tumors
Not all spinal tumors require immediate surgical treatment. Sometimes the tumor is observed over time for a change. This is a common approach in small benign (non-cancerous) tumors. Larger benign tumors, certain types of spine cancer (malignant), and progressive tumors may require surgical intervention.
A spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and/or spinal column. These cells grow and multiply uncontrollably, seemingly unchecked by the mechanisms that control normal cells. Spinal tumors can be benign (non-cancerous) or malignant (cancerous). Primary tumors originate in the spine or spinal cord, and metastatic or secondary tumors result from cancer spreading from another site to the spine.
Symptoms
Given their location, tumors in or alongside the spinal cord typically cause symptoms in the arms and/or legs including gradually worsening muscle weakness which may lead to paralysis, sensory loss or abnormal sensations, bowel or bladder problems including urinary retention, incontinence and constipation, as well as back pain.
The general location of a spinal cord tumor can often be determined based on the specific pattern of weakness and sensory loss. Cervical spinal cord tumors can lead to weakness and sensory changes of both arms and legs whereas thoracic or lumbar spinal tumors do not affect arm function.
Diagnosis
Spinal cord tumors are best diagnosed by imaging studies, typically magnetic resonance imaging (MRI) of the cervical, thoracic or lumbar spinal regions with and without gadolinium; occasionally a CT myelogram is indicated.
Treatment
The optimal treatment for a spinal cord tumor is in-part related to the type and location. However, the great majority are treated with surgical removal usually through a laminectomy and microsurgical resection. The goal of surgery is maximal but safe removal with avoidance of worsening neurological function. Tumors within the spinal cord (intramedullary) including astrocytomas, ependymomas and hemangioblastomas of the cervical, thoracic and lumbar regions, are removed as completely as possible.
Types of Spine Tumors
- Intramedullary Tumors:
-Tumors located within the spinal cord itself.
-Examples include ependymomas, astrocytomas, and gliomas. - Extramedullary Tumors:
-Tumors that occur outside a spinal cord but within the spinal canal.
-These can compress the spinal cord and nerves, causing pain, weakness, and neurological symptoms. Examples include meningiomas, schwannomas, and neurofibromas. - Vertebral (Extradural) Tumors:
-Tumors that grow in a bones of the spine (vertebrae).
-Can be primary (originating in the spine) or metastatic (spreading from other parts of the body, such as the lungs, breasts, or prostate).
Goals of Spine Tumor Surgery
- Tumor removal: To eliminate or reduce the tumor mass to prevent further damage to the spinal cord and nerves.
- Decompression: Relieving pressure on the spinal cord or nerve roots caused by the tumor.
- Spinal stabilization: If the tumor has weakened the spine, the surgeon may perform spinal fusion or place metal rods, screws, or plates to stabilize the spine and prevent fractures or deformities.
Surgical Options for Spine Tumors
- Laminectomy:
- The removal of part of the vertebra (lamina) to create space and relieve pressure on the spinal cord.
- Often used when tumors compress the spinal cord or nerve roots.
- Tumor Resection:
- This involves the complete or partial removal of the tumor. The surgeon may attempt a total resection (complete removal), but in some cases, partial resection is safer to avoid damage to the spinal cord or nerves.
- Microscopic or minimally invasive techniques may be used to carefully remove the tumor with minimal disruption to surrounding tissues.
- Spinal Fusion:
- If the tumor has compromised the stability of the spine, a spinal fusion may be performed, where two or more vertebrae are fused to provide stability.
- Metal hardware (screws, rods) may be inserted to support the spine during the healing process.
- Kyphoplasty or Vertebroplasty:
- Minimally invasive procedures used for vertebral compression fractures caused by tumors.
- Bone cement is injected into the collapsed vertebra to stabilize it and relieve pain.
- Embolization:
- For highly vascular tumors (those with a lot of blood supply), pre-surgical embolization may be performed to block the blood vessels feeding the tumor, reducing bleeding during surgery.
Surgical Process
- Preoperative Evaluation:
- Imaging studies such as MRI, CT scan, and PET scan are used to evaluate the tumor’s size, location, and involvement with the spinal cord, nerves, or vertebrae.
- A biopsy may be performed to determine whether the tumor is benign or malignant.
- Surgical Planning:
- The type of surgery depends on the tumor’s location, size, and type. The surgical approach may be through the back (posterior), side (lateral), or front (anterior) of the spine.
- Neurosurgeons or orthopedic spine surgeons, often with oncology expertise, typically perform the surgery.
- Tumor Removal and Reconstruction:
- Depending on the tumor’s location, a portion of the spine may need to be reconstructed. Spinal fusion or the use of rods and screws may be necessary to maintain stability after tumor removal.
- Postoperative Care:
- After surgery, patients may need physical therapy to regain strength or mobility.
- Pain management and rehabilitation are key components of a recovery process.
Risks of Spine Tumor Surgery
While spine tumor surgery can be life-saving, it carries some risks, including:
- Infection.
- Bleeding.
- Nerve damage: This can result in weakness, numbness, or paralysis, depending on the tumor’s location.
- Spinal fluid leakage: Cerebrospinal fluid leakage may occur but can often be managed with conservative treatment or surgical repair.
- Instability: Tumor removal can sometimes lead to spinal instability, requiring additional procedures to stabilize the spine.
Non-Surgical Treatments
- Radiation therapy: Often used for malignant tumors or residual tumor tissue that cannot be safely removed during surgery.
- Chemotherapy: May be used in cases of malignant tumors, especially if they have spread from other parts of the body.
- Targeted therapy: In some cancers, targeted drugs may help shrink or control the tumor.
- Pain management: For patients not eligible for surgery, pain management techniques such as medications, nerve blocks, or radiation therapy are essential for quality of life.Contact Us
When to Consider Surgery for a Spine Tumor
Surgery is generally recommended when:
- The tumor is causing significant pain, weakness, or neurological deficits.
- There is risk of permanent damage to the spinal cord or nerves.
- The tumor is compromising the stability of the spine.
- Non-surgical treatments (such as radiation or chemotherapy) are ineffective.Visit Our Hospital