Spine Tumor Removal Surgery in India
What is Spinal tumor?
A
spinal tumor is a development of unwanted cells in or around the spinal
cord. These tumours can be benign i.e. non-cancerous or they may be
malignant i.e. cancerous. Spinal tumors can occur inside the cord or in
the membranes (meninges) covering the spinal cord or between the
meninges and bones of the spine. It may also extend to the blood
vessels, bones of the spine, nerve roots or spinal cord cells. The
presence of spinal tumours can be determined with the help of a biopsy
or through a MRI or CT scan. Following are different types of Spinal
tumours based on there cancerous or non-cancerous behavior. - 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.
What are the Symptoms of Spinal Tumor?
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
Objective of Spinal Tumor Surgery
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.
Spinal Tumor Removal Surgery
Advanced
medical technology has enabled surgeons to remove spinal tumors that
were previously inaccessible due to potential damage and death caused by
spinal surgery. Today, neurosurgeons are able to use laser-assisted and
high-powered microscopes in a field called microsurgery.
Using
such technology, doctors are now able to distinguish between healthy and
unhealthy tissue as well as to view microscopic blood vessels and
nerves within the operating field. Throughout the spinal surgery
procedure, doctors can test the function of nerves using electrodes that
helps to prevent nerve damage. Advancements in spinal surgery
technologies also employ the use of sound waves that effectively
disintegrate tumors. Special suctioning tools remove the fragments.
Surgery : This is often the first step in treating tumors that can be removed with an acceptable risk of nerve damage.
Newer
techniques and instruments allow neurosurgeons to reach tumors that were
once inaccessible. The high-powered microscopes used in microsurgery
make it easier to distinguish tumors from healthy tissue. Doctors also
can test different nerves during surgery with electrodes, thus
minimizing nerve damage. In some instances, they may use sound waves to
break up tumors and remove the remaining fragments.
Even
with advances in treatment, not all tumors can be removed completely.
Surgical removal is the best option for many intramedullary and
intradural-extramedullary tumors, yet large ependymomas at the end of
the spine may be impossible to extricate from the many nerves in this
area. Although noncancerous tumors in the vertebrae can usually be
completely removed, metastatic tumors are less likely to be operable.
When a tumor has spread to the spine, radiation alone is usually the
treatment of choice. However, research has found that surgery combined
with radiation may be more effective at preventing loss of nerve
function in people who are healthy enough to tolerate an operation and
who have tumors that have spread from an unknown location, have some
evidence of nerve injury, have tumors resistant to radiation or have
recurrent tumors that were previously irradiated.
Recovery
from spinal surgery may take weeks or months, depending on the
procedure, and you may experience a temporary loss of sensation or other
complications, including bleeding and damage to nerve tissue.
Recovery post Spinal Tumor Surgery
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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Grades 1 and 2 tumours:
PELD
or Percutaneous Endoscopic Lumbar Discectomy is an advanced minimally
invasive spine surgery done for the decompression of the lumbar disc
space and removal of nucleus pulposus via a posterolateral approach.
PELD is also a good treatment option in management of spinal tumors and
structural deformities also in patients whose pain threshold is low or
who are not responding well to conservative treatments like pain
killers, anti inflammatory drugs and rehabilitation. 
Percutaneous
Endoscopic Lumbar Discectomy (PELD) is a unique approach for the
treatment of non-sequestrated disc herniation (disc prolapse). An
advanced minimal invasive technique, PELD is performed for the
decompression of the lumbar disc space and removal of nucleus pulposus
via a posterolateral approach. In addition to decompression surgery, the
technique has been found effective in management of spinal tumors and
structural deformities.