A spinal tumor is a rather rare disease that can be either benign or malignant. Depending on the location, a distinction is made between an intradural and an extradural spinal tumor. Spinal tumors are usually removed using microsurgical and endoscopic surgical methods. You can find further information and selected spinal tumor specialists and centers here.
A spinal tumor is a benign or malignant tumor disease in the area of the spine.
With these tumors, a distinction is made between, among other things, whether it is
is localized.
Other important criteria for assessing a spinal tumor are
Various examinations are carried out before a spinal tumor is removed:
This enables the doctor to assess the bones and their impairment. The spinal tumor can damage the spinal bones.
Other important examination methods prior to the removal of a spinal tumor are
The surgical treatment of a spinal tumor is generally carried out using the strategy of function-preserving microneurosurgery. In the case of an intradurally located spinal tumor, this involves a small approach in order to maintain the stability of the spine as far as possible.
As a rule, this operation is performed under intraoperative electrophysiological monitoring. This means that the motor and sensory nerves of the spinal cord are continuously monitored during the operation.
The spinal tumor is surgically removed using a surgical microscope. Depending on the type of lesion, the tumor is gradually reduced in size and dissected away from the healthy spinal cord.
The surgeon must spare the blood vessels and thus the blood supply to the spinal cord. The aim is to avoid permanent paralysis and loss of sensation.
The most common benign spinal tumors in the spinal canal are meningiomas. They usually have a boundary layer to the spinal cord. They can therefore usually be completely removed without neurological complications.
The individual situation and size as well as the location of the spinal tumor are always important here. The extent of the spinal cord compression and the severity of the pre-existing neurological deficits must also be taken into account.
The situation is similar for the removal of intraspinal neurinomas. They are also often very well demarcated from the spinal cord and the surrounding spinal nerves.
Due to their slow growth, neurinomas can occasionally change the bony structures. In these cases, the stability of the spinal column is at risk.
More problematic are intradural spinal tumors such as low-grade gliomas or spinal ependymomas. They grow in the spinal cord itself and may infiltrate parts of the spinal cord.
The decisive factor here is
before the operation and the extent to which the healthy spinal cord has been infiltrated.
A spinal tumor can be removed with less risk and with fewer technical problems the
However, even very long and extensive ependymomas can be removed with an acceptable range of complications if adequate microsurgical techniques are used.
Spinal hemangioblastomas are a special form. These are highly vascularized spinal tumours with a rich blood supply.
The surgical strategy here involves first coagulating and severing the blood vessels with bipolar coagulation. This enables safe dissection and removal from the spinal cord.
Multiple hemangioblastomas in the cervical spinal cord of a patient with Hippel-Lindau disease are shown here in an MRI with contrast medium. The largest tumor is located at the level of HWK 2/3 and was removed via a right hemilaminectomy.
Malignant spinal tumors are removed using the same strategy and microsurgical techniques. Due to the infiltrative and foot-like growth into the spinal cord, it may be necessary to leave residual tumor in the peripheral area. Otherwise there is a risk of damage to spinal cord function with potentially severe neurological deficits.
In the case of spinal metastases, the extent to which the vertebral bodies are infiltrated is also of crucial importance. This could jeopardize the stability of the spinal column.
Stabilization surgery may be necessary after removal of the spinal tumour. Screws and rod systems or a titanium vertebral body replacement are used.
Occasionally, catheter angiography with embolization is also necessary for spinal tumours with a high blood supply. Close cooperation with interventional neuroradiologists is therefore urgently required.
The range of postoperative complications can be reduced by
greatly reduced.
The biggest problem continues to be infiltrative spinal tumors. The surgical removal of a spinal tumor always carries the risk of neurological deficits. This is particularly the case when the spinal tumor grows into functionally relevant areas of the spinal cord.
As a rule, there are rather low risks of complications with regard to
Hospital discharge is possible after 4 - 6 days if a spinal tumor has been removed by microsurgery alone.
If stabilization surgery is also necessary, convalescence usually takes a few days longer.
Occasionally, follow-up treatment is also carried out. In the case of a malignant tumor, this is usually followed by
If the patient is mobile enough, chemotherapy can usually be carried out on an outpatient basis.
The range of complications and risks associated with the surgical removal of spinal tumors has been significantly reduced through the use of microsurgical and endoscopic surgical methods under intraoperative electrophysiological monitoring.
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