Surgical Treatment of Spine Cancer
Edited By: Sohail K. Mirza, M.D. MPH
Last updated Friday, December 30, 2005
Recovering from surgeryPain and pain management In percutaneous procedures, local anesthesia may be all that
is needed during the procedure. Pain is usually tolerable so oral narcotics are
sufficient to manage patient pain afterwards.
With open procedures, general anesthesia is administered
during the surgery and often a pain specialist provides assistance in managing
the pain after surgery. Open procedures can be quite painful, and specialists
trained in management of cancer pain and surgical pain are usually involved to
provide optimal post-operative pain control.
Before surgeries are performed on patients who have spinal
cancer, an anesthesiologist usually meets with the patient to discuss his/her
health needs and address preferences, comfort and safety. Use of medications Following percutaneous procedures, patients receive pain
medication intravenously for a few hours and then switch to oral narcotics.
They will usually take the oral medication for four to five days.
Following open procedures, patients are often monitored by a
team of specialists dedicated to providing post-operative pain control.
Patients receive pain medication intravenously (patient controlled
analgesia—PCA) for three to four days and gradually switch to oral narcotic
pain medication. Oral narcotics are usually taken for one to two months to manage post-operative pain.
Patients with spinal cancer are usually prescribed
antibiotics immediately before surgery and for three or four days following
surgery to reduce the chance of infection. Due to prior radiation treatment and
chemotherapy, infection risk is high in patients having spine surgery for
cancer. Effectiveness of medications The effectiveness of pain medication following spinal
surgery varies depending on the patient’s condition and the procedure he or she
has undergone.
In general, patients undergoing spinal cancer surgery may
require additional pain medication to manage their pain. This is why cancer
surgery patients are frequently even more closely monitored both during and
after surgery by an anesthesiologist and/or other acute pain specialists who
may be on staff with a medical center’s cancer center. Important side effects The most common side effect of taking pain medication after
spinal surgery is nausea. Adjustments can be made to the timing, dosage and
type of the medication to alleviate this side effect.Hospital stay After a percutaneous procedure patients often go home a few
hours after the surgery.
After an open procedure, patients are usually encouraged to
sit up the day after surgery. Then they are encouraged to walk with assistance
from a physical therapist within two or three days. Patients generally are
discharged after five to seven days in the hospital. They can usually go home
when they can take care of themselves independently, such as getting in and out
of bed on their own, walking and going up and down a few steps independently,
and go to the bathroom independently.
In a staged procedure, patients are usually in the hospital
five to seven days after the second operation. If the procedures are performed
one week apart, the patient may be in the hospital for 12 to 14 days.Recovery and rehabilitation in the hospital While patients are in the hospital following spinal cancer
surgery, they are encouraged to sit up after the first day. Then two to three
days later, they are encouraged to walk with assistance from a physical
therapist. The therapist also provides the patient instruction on how to safely
get in and out of bed or a car, climb steps, etc. before the patient goes home.Hospital discharge The following general recommendations apply to most patients
after they have spinal cancer surgery:
- The sutures will be left in for four to six
weeks. Whereas with most surgeries, sutures can be removed after 10 days.
Sutures are left in place longer in patients who have had radiation or are
undergoing chemotherapy. This is because radiation results in
scarring and reduced blood flow in the tissues contained in the radiation
area, both of which slow down and interfere with wound healing.
Chemotherapy also slows down tissue healing.
- For
the first three months, patients are encouraged to avoid bending,
twisting, or lifting. They may do general conditioning exercises, such as
walking or cycling on a stationary bike, or swimming. They should limit
lifting to no more than five pounds to allow time for the bones to heal.
- After
three months, physical therapy is encouraged.
- For
the first three to six months, patients should limit lifting to no more
than 20 pounds
- After
six months, once bone healing is complete, there are usually no lifting
restrictions.
Convalescent assistance After spinal cancer surgery, patients can usually go home to
recover, but they will need assistance with activities of daily life, such as
cooking, bathing, cleaning, and shopping for approximately four to six weeks. If
a family member or friend is not available to provide assistance, a care giver
will be needed.
A visiting nurse may also be needed during this time,
particularly if the patient is taking antibiotics for an extended period of
time due to his or her cancer treatment.
If the patient has complete or partial paralysis, he or she
may need to recover from surgery at a skilled nursing facility.
If a patient is having difficulty with activities of daily
life, a brief stay at a rehabilitation facility may be advisable until he or
she is stabilized and is able to do most things on his or her own. 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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