For patients with slow growing primary intradural spinal tumors such as meningiomas and schwannomas, surgery if often curative. The surgery involves the removal of the bony roof of the spinal canal (lamina) to expose the dura which is the covering of the spinal cord and nerve roots. The dura is then opened and the tumor is removed very carefully with the aid of the operating microscope and advanced microsurgical techniques. In order to ensure the highest level of safety during your surgery, the function of the spinal cord and nerves is routinely monitored during surgery. These intraoperative nerve monitoring techniques help the surgeon to avoid damaging nerves during surgery.
If you have a metastatic spine tumor (a tumor in the spine that began elsewhere in your body), surgery could potentially help to stabilize your spine, reduce pain, prevent paralysis, and increase your mobility. These tumors can be approached via an anterior, lateral, posterolateral or posterior approach. Sometimes following tumor removal, fixation of the spine using special instrumentation is required to redistribute stress on the bones and to keep them aligned. These palliative surgical techniques can provide local control of cancer while allowing the patient to return to other treatments such as chemotherapy or radiation. In some situations, spinal cord decompression is done to create enough space so that high-dose radiation can be given without putting the spinal cord at risk of significant injury.
Spinal angiography with tumor embolization is performed prior to surgery when dealing with tumors with an abnormally large number of blood vessels. In this procedure the blood vessels are identified by injecting dye into the tumor and then the interventional radiologist injects a special substance into the blood vessels to stop the blood flow. This procedure significantly reduces the risk of bleeding during surgery and is a very powerful adjunct in select cases of highly vascular spinal tumors.