Surgical Treatment of Spine Cancer
Edited By: Sohail K. Mirza, M.D. MPH
Last updated Friday, December 30, 2005
About the procedureTechnical details In general, spinal tumor surgical procedures include:
- Percutaneous,
minimally invasive outpatient surgery using local anesthesia.
- Percutaneous
minimally invasive surgery using general anesthesia and a short hospital
stay.
- Surgery
with an incision in the back or neck to free-up the space around the
spinal cord and to insert rods, screws, and cement to reinforce the spinal
column (for example, laminectomy, fusion, pedicle screw fixation,
posterior instrumentation, and methyl-methacrylate/ bone cement
augmentation).
- Surgery
with an incision across the abdomen, chest, or front of the neck to free
up the space around the spinal cord and to insert plates and screws to
reinforce the spinal column (for example, corpectomy, vertebrectomy,
anterior fusion, and anterior instrumentation).
- Extensive
surgery with two incisions, one in the back and one in the front, to free
up the spinal cord and reinforce the spinal column. Often the anterior and
posterior procedures are staged to occur one week apart.
Percutaneous spinal tumor surgery
usually involves cement being injected into a fractured vertebra. Often the tumor
can be indirectly scraped and removed through these minimally-invasive
techniques (percutaneous curettage). Percutaneous surgical procedures involve
the passage of substances and/or instruments, such as a needle, wires, drills,
or catheters through the skin without a formal incision. These procedures are
used if the patient has no neurological symptoms.
If there are neurological
symptoms, an open procedure is usually necessary where an incision is made to
remove tissue pressing against the spinal cord and nerves. These procedures
usually require insertion of rods, screws and cement to reinforce the spinal
column. If an open procedure is needed, often a pre-operative embolization is
done to block the flow of blood to the spinal tumor and help reduce blood loss
during surgery.
Sometimes a more extensive
approach is required, particularly when aiming for a cure in excising primary
tumors of the spinal column or excising an isolated, solitary metastasis (spread of cancer away from the location where
it started) from the spinal column. The more extensive procedure is
usually done in stages. A first surgery may be done from the back to separate
the tumor from the spinal cord and reinforce the vertebral column. A second
operation is then performed from the front, usually through the chest or
abdomen, to release the tumor from blood vessels and other organs, remove the
tumor and to further reinforce the spinal column. Sometimes both stages can be
completed on the same day, under one anesthetic. More often, because the first
operation may take a long time or involve a lot of blood loss, the patient is
allowed to recuperate for five to seven days before undergoing the second stage
of the operation. Whether staging is necessary and the particular sequence of
steps and whether the first part is performed through a back or a front
incision depends on the particular circumstances of tumor location and the
patient’s symptoms, among other factors.Anesthetic Sometimes, with percutaneous procedures, patients receive
only a local anesthetic. But with most spinal cancer surgeries, patients
receive a general anesthetic.Length of spine tumors; neoplasms of the spine; spine cancer; pathological fractions of the spine Percutaneous spinal surgeries usually take approximately one
hour.
Open, extensive spinal cancer surgeries typically take four
to six hours and may be staged if very complex.
Complex tumor excision (tumor removal) can take more than 10
hours. Surgery for Spine tumors; neoplasms of the spine; spine cancer; pathological fractions of the spine at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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