SPINAL TUMOR SURGERY

Spinal Tumor Surgery In India

The spine is composed of individual bones (vertebrae) stacked one on top of the other in a column. Each vertebra possesses a cylindrical body, which participates in weight bearing and an arch of bone (laminae and spinous processes) which protects the spinal cord and its coverings. The bony arch is connected to the body by two small columns of bone (pedicles). The circular canal between the body, arch, and pedicles houses the spinal cord and is called the spinal canal.

The spinal cord is contained within the spinal canal and is covered by a layer of connective tissue, the dura mater. Tumors which are located outside the dura are called extradural. These are usually metastatic tumors and most often arise in the vertebrae themselves. Tumors arising inside the dura, but outside the actual substance of the spinal cord are termed intradural-extramedullary. These are usually nerve sheath tumors or meningiomas. Tumors arising within the substance of the spinal cord itself are called intramedullary tumors. These are usually astrocytomas or ependymomas. Different types of tumors often behave differently and require different treatments.

Causes

Any Type Of Tumor May Occur In The Spine, Including : –

• Leukemia
• Lymphoma
• Myeloma

A small number of spinal tumors occur in the nerves of the spinal cord itself. Most often these are ependymomas and other gliomas.

Tumors that start in spinal tissue are called primary spinal tumors. Tumors that spread to the spine from some other place (metatastasis) are called secondary spinal tumors.

The cause of primary spinal tumors is unknown. Some primary spinal tumors occur with genetic defects. A spinal tumor is much less common than a primary brain tumor.

Spinal tumors can occur : –

• Inside the cord (intramedullary)
• In the membranes (meninges) covering the spinal cord (extramedullary – intradural)
• Between the meninges and bones of the spine (extradural)

Symptoms : –

• Abnormal sensations, loss of sensation : –
  1. Especially in the legs (may be in the knee or ankle, with or without shooting pain down the leg)
  2. May worsen

• Back pain : –
  1. Gets worse over time
  2. In any area middle or low back are most common
  3. Is usually severe and not relieved by pain medication
  4. Is worse when lying down
  5. Is worse with strain, cough, sneeze
  6. May extend to the hip, leg, or feet (or arms), or all extremities
  7. May stay in the spine

Exams and Tests in India

A nervous system (neurologic) examination may find the location of the tumor.

The health care provider may also find the following during an exam : –

• Abnormal reflexes
• Increased muscle tone
• Loss of pain and temperature sensation
• Tenderness in the spine

Surgical Treatment of Spinal Tumors in India

Surgical options for the treated of spine tumors vary from complete to partial removal. Surgical stabilization of the spine may be necessary as a result of instability caused by tumor itself or the surgery to remove it. This may be done by surgery approach from the front or back of spine. This may involve going through the neck, chest or abdomen. Newer techniques and instruments allows that were once inaccessible. The high powered microscopes used in microsurgery for instance make it easier to distinguish tumors from healthy tissue. The typical hospital stays after surgery to remove a spinal tumors range from approximately 5 to 10days

Recovery

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.

Treatment may include radiation and/or chemotherapy. The side effects from radiation can be severe including reddened or painful skin at the treatment site, nausea, vomiting, loss of appetite, and fatigue. Chemotherapy can cause similar side effects. However, many of these side effects can be treated with drugs.