Let’s start to examine spinal tumors and their treatments with disease symptoms and diagnostic methods.
Benign or malignant abnormal tissue masses (lesions) that originate from the spine itself, the surrounding muscle tissues, ligaments, nerve cells, and membranes in the spinal cord are called spinal cord tumors. Approximately 10-25% of central nervous system tumors constitute vertebral tumors. Depending on the location of the tumor, the primary complaint is specifically low back, back, and neck pain. In the early phase, patients usually consult a doctor with pain complaints. Coughing, straining, and sneezing are reasons that increase intracranial pressure. The pain initially increases with coughing, straining, and sneezing and is relieved by rest. As the disease progresses, the pain cannot be tolerated even with rest. Pain in metastatic spine tumors usually occurs during rest at the beginning but becomes continuous as the disease progresses. While the pain initially improves with medical painkillers, it increases later continuously to the extent which blocks a person’s activity, and they become resistant to medical drugs.
There are various diseases of the spine. Treatment approaches specific to each disease and patient are different. Genetic predisposition also plays a vital role in spinal diseases. Spine wear occurs faster in those with a genetic predisposition.
The patient’s complaints and symptoms vary according to the location of the tumor.
Weakness or numbness in the arms and legs
- Numbness in the chest and limbs
- Difficulty walking
- Loss of sense of pain and sense of heat exchange
- Deterioration of bowel and bladder control
- Paralysis can be in varying degrees
- Scoliosis or other spinal deformities (may be the result of large but benign tumors)
- Tumors Disrupt the Biomechanics of the Spine
Spinal tumors have two sources. It can arise from the cells that make up the spine and spinal cord, as well as by the spread of tumors that develop in different parts of the body. The bones where metastases are most common are the spine. Sometimes primary tumors can be metastatic in some cases. In other words, tumors that occur elsewhere in the body can easily spread to the spine, as they are a very blood-bearing structure. When the tumor is malignant, it disrupts the muscle, bone, and membrane structure of the spine. In the area where the tumor is located, it also disrupts the biomechanics of the spine. In addition, it can cause severe pain and paralysis by putting pressure on the nerves.
In the treatment of spinal tumors, many evaluations are made such as the location and type of the tumor and which tissues will be removed in the surgery. In benign tumors, removing the tumor completely provides complete recovery. Primary malignant tumors of the spine or secondary tumors caused by metastasis from other organs cause compression on the spine. When necessary, surgical and/or oncological treatments can be performed together to eliminate this pressure on the spinal cord. In surgical operations where the spine must be removed, rods, screws, and prosthetic structures similar to the spine are placed.
Spine surgery should be performed with a multidisciplinary approach and in full-fledged centers. Please contact our consultants to reach experienced spine health centers with high surgical success rates and to plan your treatment.
What are the diagnostic methods?
The first stage of diagnosis is the examination of the patient. Among the diagnostic methods, the gold standard is contrast-enhanced (medicated) magnetic resonance imaging. Sometimes computed tomography and electromyography (EMG) can also be used for differential diagnosis and surgery planning.
How is it treated?
Surgery is the first and most effective treatment option for spinal tumors. Complete recovery can be achieved by surgically removing spinal tumors, which are generally benign.
If there is a suspicion of a malignant tumor, a part of the tumor should be surgically removed to determine the type of tumor and to plan the subsequent treatment. If there is a worsening, such as an increase in weakness, in the patient’s neurological examination, the first treatment option is surgery. Different methods have been described in surgery, sometimes in addition to these techniques, the pedicle screw (PS) system or cortical bone trajectory (CBT) technique is used for spinal reconstruction and stabilization.
Proper technique is crucial in surgical success. In order to prevent permanent damage to the patient, classical microsurgical methods should be used properly, and neuromonitoring should be performed during the operation. With the neuromonitoring method, the neural communication on the spinal cord is continuously measured during the operation, and the surgeon can predict any possible damage during the interventions.
Are additional treatments required?
Radiotherapy (radiation therapy) is a treatment option for some spinal tumors. If the tumors do not need to be removed, they can be followed up intermittently. Some tumors respond well to chemotherapy, while others respond well to radiotherapy. In some tumors known to be generally malignant, radiotherapy is used after pathological sampling.
How Does the Post-Surgery Process Progress?
The patient is taken to the service. He is observed in intensive care overnight and then taken to the service. On the first day of the operation, the patient walks with a corset and cervical collar. The patient can be discharged on the 3rd day of the post-operation. Sutures are removed on the 12th day after surgery.