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Dr. Paresh Bang
Consultant Spine Surgeon
Surgery for spine tumors In Yavatmal
Surgery for spine tumors
Surgery for spine tumors is a critical procedure aimed at removing or reducing the size of a tumor located in or around the spinal column. Spine tumors can be either benign (non-cancerous) or malignant (cancerous), and their treatment depends on the type, size, and location of the tumor, as well as the patient’s overall health.
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.
Types of Spine Tumors
Primary Tumors
- Benign: Osteomas, hemangiomas, schwannomas, meningiomas.
- Malignant: Osteosarcoma, chondrosarcoma, multiple myeloma, and lymphoma.
- Metastatic Tumors: These are cancers that spread (metastasize) from other parts of the body (e.g., breast, lung, prostate, kidney) to the spine. Metastatic tumors in the spine are more common than primary spinal tumors.
Intramedullary Tumors:Tumors that develop inside the spinal cord, such as ependymomas or astrocytomas.
Extramedullary Tumors:Tumors that develop outside the spinal cord but within its protective membranes or bones. These can include schwannomas or meningiomas.
Goals of Surgery for Spine Tumors
Tumor Removal or Reduction: The primary goal is to remove as much of the tumor as possible, especially if it is causing neurological symptoms, pain, or instability in the spine.
Spinal Stabilization: If the tumor has weakened the spine, additional procedures like spinal fusion may be performed to stabilize the spine.
Decompression of the Spinal Cord or Nerves: Some tumors press on the spinal cord or nerves, causing pain, weakness, or paralysis. Surgery can relieve this pressure.
Improvement of Quality of Life: Surgery is aimed at reducing pain, preserving neurological function, and improving the patient’s quality of life.
Types of Spine Tumor Surgery
Complete Resection (Total Removal)
- Benign Tumors: In those benign tumors that are well-defined and can be removed entirely, the surgeons try to remove the tumor entirely without removing its surrounding tissues.
- Malignant Tumors: If a malignant tumor is localized only in a certain area and can be removed without causing any severe defect to the patient, then total resection can be made. Total resection is often achieved with difficulty with malignancies since they are invasive.
Partial Resection (Debulking)
- If it is not possible to remove the tumor totally (for example, because the tumor is so very tangled with vital nerves or structures), one can remove as much of it as possible to remove symptoms like pain or pressure from the spinal cord.
- It is often carried out for malignant tumors or big benign tumors that cannot be totally removed without risking surgical complications.
Spinal Cord Decompression
- If the tumor is compressing the spinal cord or nerves, surgery will probably alleviate the pressure and prevent further deterioration of the neurological status. This should then restore or preserve motor function, sensation, and bladder or bowel control.
Spinal Stabilization Surgery
- If the tumor has weakened the bones of the spine, there’s a risk that the spine might become unstable and either collapse or deform. To prevent this, surgeons stabilize the spine with procedures such as:
- Spinal Fusion: The joining of two or more vertebrae to stabilize the spine.
- Instrumentation: Allows the support of rods, screws, or plates to be placed into the spine
Minimally Invasive Spine Surgery (MISS):
- Surgery can, in some cases, be carried out through minimally invasive techniques for removing smaller tumors or for a biopsy. Special instruments are used by surgeons to directly access the tumor, with small incisions to be made that minimize tissue damage and get the patient back on his feet sooner.
Advantages: There is less postoperative pain, reduced recovery time, and smaller scars.
Kyphoplasty or Vertebroplasty
- These procedures can be used for patients whose tumors have resulted in compression fractures of the vertebrae. Kyphoplasty is a procedure wherein a balloon is put into the vertebra, inflated, and then filled with bone cement. The similar procedure is Vertebroplasty, without the inflatable balloon.
These are relatively common in cases where cancer has weakened the vertebrae and is causing fractures.
Alternative and Complementary Treatments
- Radiation Therapy: Used to shrink tumors or destroy remaining cancer cells after surgery, especially for malignant tumors.
- Chemotherapy: May be used for certain types of cancers that affect the spine, particularly when the tumor is metastatic.
- Stereotactic Radiosurgery (CyberKnife or Gamma Knife): A form of precise, high-dose radiation therapy used for smaller tumors or those in difficult-to-reach areas of the spine. This can sometimes be an alternative to traditional surgery.
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.
Recovery After Spine Tumor Surgery
- Hospital Stay: The length of stay depends on the complexity of the surgery, but patients may stay in the hospital for a few days to a week or more.
- Postoperative Care: Pain management, wound care, and physical therapy are key components of recovery. Patients may need physical therapy to regain mobility and strength, especially if nerves or the spinal cord were affected.
- Monitoring: Regular follow-ups, including imaging (MRI or CT scans), are necessary to monitor the area for tumor recurrence or complications from the surgery.
- Rehabilitation: If neurological symptoms were present before surgery, rehabilitation may be needed to help regain function in affected limbs or areas of the body.Contact Us
When to Consider Surgery for a Spine Tumor
Surgery is generally recommended when:
- Neurological Symptoms: Surgery is often urgent if a tumor is compressing the spinal cord or nerves, causing pain, numbness, weakness, or loss of bladder or bowel control.
- Spinal Instability: If the tumor has compromised the structural integrity of the spine, surgery may be needed to prevent spinal collapse.
- Tumor Growth: If the tumor is growing rapidly or is malignant, surgery may be needed to remove or reduce it to prevent further damage.
- Pain: If pain caused by the tumor is severe and not managed by conservative treatments, surgery may be necessary.Visit Our Hospital