Spine Tumor Removal Surgery
Spinal tumor, most back pain is associated with stress, strain and aging — not with a tumor. In most areas of your body, noncancerous tumors aren't particularly worrisome. That's not necessarily the case with your spinal cord, where a spinal tumor or a growth of any kind can impinge on your nerves, leading to pain, neurological problems and sometimes paralysis. A spinal tumor, whether cancerous or not, can threaten life and cause permanent disability. Yet advances in spinal tumor treatment offer more options than ever before.
Although back pain is the most common indication of a spinal tumor, most back pain is associated with stress, strain and aging — not with a tumor. In most areas of your body, noncancerous tumors aren't particularly worrisome. That's not necessarily the case with your spinal cord, where a spinal tumor or a growth of any kind can impinge on your nerves, leading to pain, neurological problems and sometimes paralysis. A spinal tumor, whether cancerous or not, can threaten life and cause permanent disability. Yet advances in spinal tumor treatment offer more options than ever before.
Benign bone tumors are of following types:
• Giant Cell Tumor: Usually found in the sacrum
• Hemangioma: Usually found in the thoracic spine
• Osteoid Osteoma: Usually found to affect the lumbar spine's posterior spinal column
• Osteoblastoma: Usually found to affect the spine's posterior spinal column Malignant bone tumors are classified as follows:
• Chordoma: Affects the sacrum and coccyx in the midline
• Osteosarcoma: affect the anterior vertebral body and it may also invade the Posterior spinal elements.
Malignant cartilage tumor:
• Chondrosarcoma; Found primarily in the thoracic, lumbar, and sacral spine
Malignant plasma cell tumors:
• Plasmacytoma is cancer of the white blood cells (plasma cells) which effects the thoracic spine and may also involve the spinal cord ot the nerve roots.
• Lymphomas are cancer of the body's lymphatic system that may spread to the spine .Usually the anterior part (front) of the spinal column is affected
• Ewing's Sarcoma: It affects the Sacrum or the nerves.
There is a rapid increase in technology that allows the MIS physician to treat patients with minimally invasive spine surgery procedures. Some of these techniques are now well established, while others remain new and continue to evolve. The best MIS (Minimally Invasive Spine Surgery) technique will depend on the specific character of the problem. While the list of MIS (Minimally Invasive Spine Surgery) techniques continues to expand, the most commonly employed today include:
• Minimally Invasive Tubular Microdiscetomy
• Minimally Invasive Lumbar Laminectomy
• Cervical laminoforaminotomy
• Endoscopic Discectomy
• Minimally Invasive Transforaminal Interbody Lumbar Fusion (TILF)
• Minimally Invasive eXtreme Lateral Interbody Fusion (XLIF)
• Microsurgical Discectomy
• Posterior Lumbar Interbody Fusion (PLIF)
• Kyphoplasty
• Nucleoplasty or Percutaneous Discectomy
Tumor may cause generalized symptoms in the body (like persistent low energy levels, unexplainable weight loss, lump formation, enlargement of lymph nodes, malaise, irregularities of menstruation in females etc) as well as symptoms pertaining to the affected organ in the body. In case of spinal tumor the patient may present with any of the following
• Back pain, often radiating to other parts of the body and worse at night
• Loss of sensation or muscle weakness, especially in the legs
• Difficulty walking, sometimes leading to falls
• Paralysis may occur in varying degrees and in different parts of the body, depending on which nerves are compressed.
• Scoliosis or other spinal deformity resulting from a large, but non cancerous tumor
• Erosion and Destruction of vertebral body
The primary objective of the surgery is to reduce the pain caused by the spinal tumor, to restore and preserve neurological function and provide spinal stability. Spinal Tumor surgery is generally indicated in case there is a localized tumor which can be removed with minimum damage to nerve and spinal cord, or there is persistent neurological deficit and pain which is unresponsive to non operative treatment, or there is vertebral bone destruction affecting spinal stability. Surgery may include resection (partial removal) or excision (complete removal) of tumor. When the tumor is removed (partially or completely) pain and neurologic problems may clear up.
Depending on the type of spinal tumor and its location, surgery may include one or more of the following procedures: -
Decompression : - Remove the tumor, bone, and other tissues compressing the spinal cord and or spinal nerve roots.
Spinal Stabilization : - Your spine can become unstable after part of the bone or other tissues (e.g., intervertebral discs) are taken out. An unstable spine can move in abnormal ways, putting you more at risk for serious neurological injury. In this case, the surgeon will want to stabilize your spine by using instrumentation and fusion.
In spine stabilization by fusion, the surgeon creates an environment where the bones in your spine will fuse together over time (usually over several months or longer). The surgeon uses a bone graft (usually using bone from your own body, but it's possible to use donor bone as well) or a biological substance (which will stimulate bone growth). Your surgeon may use spinal instrumentation-wires, cables, screws, rods, and plates-to increase stability as the bones fuse. The fusion will stop movement between the vertebrae, providing long-term stability.
Combination : - You may need to have both a decompression and spinal stabilization. Decompression and stabilization spine surgeries may be performed as a minimally invasive procedure or by using a more traditional open approach (longer incision, longer recovery time).
Kyphoplasty or Vertebroplasty : - These are similar minimally invasive surgical procedures performed to stabilize a fractured vertebra. Spinal tumors that invade vertebrae may cause it to break and can cause severe pain.
Kyphoplasty uses a special orthopaedic balloon. It's inserted into the fractured vertebra. Then, the balloon is inflated in an effort to return the vertebra to the correct height and position. The balloon creates a void-a hole-in your vertebra, and it's then removed. The void is filled in with a surgical cement that should support the vertebra and keep it from fracturing again.
Vertebroplasty does not use a balloon, but it does involve injecting surgical cement into the vertebral body. Both procedures provide immediate fracture stabilization.
• When the tumor is removed (partially or completely) pain and neurologic problems may clear up.
• To restore and preserve neurological function and provide spinal stability.
• Spinal Tumor surgery is generally indicated in case there is a localized tumor which can be removed with minimum damage to nerve and spinal cord,
• There is persistent neurological deficit and pain which is unresponsive to non operative treatment
• Surgery may include resection (partial removal) or excision (complete removal) of tumor.
Recovery post Spinal Tumor surgery depends on patient’s health before surgery. The patient’s care is monitored by periodical office visits and re-evaluation by the treating physician. This is important because some tumors, benign or malignant, may reoccur. Usually when the treatment period has ended, the symptoms clear up.
Analgesics are given to control post-operative pain and cancer pain. Cancer pain may be difficult to control (e.g. ‘break through pain’). A pain management specialist may provide assistance if conventional drugs (e.g. pill, skin patch) do not provide relief. Any surgery, radiation treatment or chemotherapy can drain the patient nutritionally. Therefore, a proper diet is important to regain strength, lost weight, and a measure of health. A professional nutritionist can provide guidance. Depending on the extent of the surgery and the patient’s medical status, a course of physical therapy may be prescribed. Through exercise and modalities the patient can build strength, endurance and flexibility.
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