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Spine Tumour Surgery

Dr Vivek Agrawal > Spine Tumour Surgery

What Is Spine Tumour Surgery ?

A spinal tumour is a growth that develops within your spinal canal or within the bones of your spine. A spinal cord tumour, also called an intradural tumour, is a spinal tumour that that begins within the spinal cord or the covering of the spinal cord (dura). A tumour that affects the bones of the spine (vertebrae) is called a vertebral tumour.

Spinal cord tumours may be classified as one of three different types depending on where they occur relative to the protective membranes of the spinal cord.

These are the main types of intradural tumours:

  • Intramedullary tumours begin in the cells within the spinal cord itself, such as gliomas, astrocytoma or ependymomas.
  • Extra medullary tumours grow in either the membrane surrounding the spinal cord or the nerve roots that reach out from the spinal cord. Although they don’t begin within the spinal cord itself, these types of tumours may affect spinal cord function by causing spinal cord compression and other problems. Examples of extramedullary tumors that can affect the spinal cord include meningiomas, neurofibromas, schwannomas and nerve sheath tumours.

Tumors from other parts of the body can spread (metastasize) to the vertebrae, the supporting network around the spinal cord or, in rare cases, the spinal cord itself. Spinal tumours or growths of any kind can lead to pain, neurological problems and sometimes paralysis. A spinal tumour can be life-threatening and cause permanent disability.

Symptoms

Spinal cord tumors can cause different signs and symptoms, especially as tumors grow. The tumors may affect your spinal cord or the nerve roots, blood vessels or bones of your spine. Signs and symptoms may include:
  • Pain at the site of the tumor due to tumor growth
  • Back pain, often radiating to other parts of your body
  • Feeling less sensitive to pain, heat and cold
  • Loss of bowel or bladder function
  • Difficulty walking, sometimes leading to falls
  • Back pain that’s worse at night
  • Loss of sensation or muscle weakness, especially in your arms or legs
  • Muscle weakness, which may be mild or severe, in different parts of your body
Back pain is a common early symptom of spinal tumors. Pain may also spread beyond your back to your hips, legs, feet or arms and may worsen over time even with treatment.

Causes

It’s not clear why most spinal tumors develop. Experts suspect that defective genes play a role. But it’s usually not known whether such genetic defects are inherited or simply develop over time. They might be caused by something in the environment, such as exposure to certain chemicals. In some cases, however, spinal cord tumors are linked to known inherited syndromes, such as neurofibromatosis 2 and von Hippel-Lindau disease.

Investigation

If your doctor suspects a spinal tumor, these tests can help confirm the diagnosis and pinpoint the tumor’s location:

  • Spinal magnetic resonance imaging (MRI). MRI uses a powerful magnetic field and radio waves to produce accurate images of your spine, spinal cord and nerves. MRI is usually the preferred test to diagnose tumors of the spinal cord and surrounding tissues. A contrast agent that helps highlight certain tissues and structures may be injected into a vein in your hand or forearm during the test.
  • Computerized tomography (CT). This test uses a narrow beam of radiation to produce detailed images of your spine. Sometimes it’s combined with an injected contrast dye to make abnormal changes in the spinal canal or spinal cord easier to see. A CT scan is only rarely used to help diagnose spinal tumors.
  • Biopsy. The only way to determine the exact type of a spinal tumor is to examine a small tissue sample (biopsy) under a microscope. The biopsy results will help determine treatment options.

Treatment

Treatment options for most spinal tumors include:

  • During observation, your doctor will likely recommend periodic CT or MRI scans at an appropriate interval to monitor the tumor.
  • This is often the treatment of choice for tumors that can be removed with an acceptable risk of spinal cord or nerve injury damage.
  • Radiation therapy.This may be used to eliminate the remnants of tumors that remain after surgery, to treat inoperable tumors or to treat those tumors where surgery is too risky.
  • A standard treatment for many types of cancer, chemotherapy uses medications to destroy cancer cells or stop them from growing. Your doctor can determine whether chemotherapy might be beneficial for you, either alone or in combination with radiation therapy.
  • Other drugs.Because surgery and radiation therapy as well as tumors themselves can cause inflammation inside the spinal cord, doctors sometimes prescribe corticosteroids to reduce the swelling, either after surgery or during radiation treatments.