For benign spinal tumors that don’t cause symptoms or don’t appear to be progressing, physicians might recommend holding off on surgery. Instead, they will monitor the tumor through regular MRIs, or see if it responds well to chemotherapy or radiation.
Surgery is often the best option, though. Some spinal tumors resist radiation and chemotherapy, while others are too large or already pressing on nerves and causing other health issues. Surgeons want to avoid tumor growth that will inevitably press on spinal nerves and lead to paralysis. Yet, spinal surgeons don’t make that decision alone.
They work with the patient as well as other physicians and surgeons to develop the best course of action.
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Spinal cancer treatment sometimes involves surgery. We apply similar surgical strategies for brain tumors and spinal column tumors. The goal of spinal cancer surgery depends on several factors, including the location and grade of the tumor, and the symptoms present.
When the tumor is limited to one portion of the spinal column, we may perform surgery to remove the cancer. For metastatic spinal tumors, we may perform surgery to relieve symptoms. For example, we commonly use surgical strategies to treat spinal column compression and instability, and relieve pain. Spinal cancer surgery may also help remove tissue pressing against the spinal cord and nerves or to relieve the buildup of cerebrospinal fluid.
In the past, surgeries to address spinal tumors were relatively large. With advances in technology, we perform many of these surgeries in a minimally invasive fashion. Minimally invasive spinal surgeries allow you to get back on your feet and return to normal activities more quickly, with less pain. This also allows you to maintain your nutritional health and get back to treatment faster.
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Our medical oncologists treat primary and metastatic spinal cancer with an aggressive and creative approach, selecting spinal cancer chemotherapy drugs and delivery methods based on your individual needs.
Chemotherapy drugs may be administered orally in pill form or injected into the vein. For some spinal tumors, drugs may be given directly into the cerebrospinal fluid. You may receive chemotherapy alone, or in combination with other spinal cancer treatments, such as surgery and/or radiation therapy.
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We use highly targeted delivery systems that allow us to increase the dose and precision of radiation to a spinal tumor, while reducing damage to healthy tissue.
Spinal cancer radiation therapy is commonly used following surgical resection of a tumor, to destroy microscopic tumor cells left behind. It may also be an option for metastatic spinal tumors (tumors that have spread to the spine from another part of the body).
The specifics of your radiation regimen will be based on several factors, including the type and size of the spinal tumor and the extent of disease. External radiation therapy is commonly used for spinal cancer. The area radiated typically includes the tumor and an area surrounding the tumor. For metastatic spinal tumors, radiation is sometimes given to the entire spine.
With interventional radiology, our doctors can visualize tumors and perform real-time image-guided interventional procedures. We can take biopsies, deliver treatment directly to tumors, provide palliative treatment, and monitor your response to treatment.
Kyphoplasty and vertebroplasty are examples of minimally invasive procedures used to treat compression fractures of the spinal vertebrae caused by spinal cancer. Compression fractures of the spinal vertebrae can cause severe back pain, spinal deformity, and loss of height. Our doctors may perform kyphoplasty or vertebroplasty to rebuild cracked or collapsed vertebrae.
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Although some spinal tumor surgery may only require two or three days in the hospital, it’s not uncommon to stay in the hospital for up to a week after undergoing surgery for an extensive tumor. During this time, you will have the opportunity to rest and really begin the healing process. Depending on the site and severity of your tumor, you may start receiving physical therapy. Pain management will be administered, but will be decreased on a daily basis as your body starts to recover.
Your surgeon may have placed a drain to divert excess fluid from the surgical site within a few days of placement, this drain will be removed.
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In most cases, you will go home within a week or less after your surgery, but sometimes a stay in an in-patient rehabilitation facility is needed. You might still be on pain medication for a few days to several weeks. It’s important to keep up with your medication schedule as laid out by your surgeon.
At home, you can gradually start to become more active depending on your surgeon’s instructions, you may be asked to walk and build upon that base as recovery continues. In some cases physical therapy will be prescribed be sure to attend all of the required sessions. This often makes a huge difference in recovery and helps to build strength and flexibility again.
A well-balanced diet is essential in giving your body the nutrients it needs to properly heal. Plenty of vegetables and fruits, a moderation of lean meats and healthy carbs will help give your system the boost it needs. Rest is also important because you will feel very tired to start with, but as time goes by, you’ll find your energy will start to increase again.
You’ll be allowed to shower as normal, but avoid scrubbing your incision site. It may be healed over, but there is still a lot of rebuilding that needs to take place under the surface.
You may need to see your surgeon regularly over the course of the next few weeks. Be sure to make all of the appointments it’s essential that your progress be monitored closely. It’s much easier to correct issues early on.
Depending on what you do for work, it’s possible you’ll be able to return fairly quickly. If you work in a job that demands strenuous labor, such as lifting, bending or twisting, you may be ordered to work on a modified basis until your surgeon has cleared you for resuming your normal duties.
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You’ve made it through the first (and typically most difficult) portion of your recovery! At this point, you have resumed the majority of your normal activities, including driving, working and household chores. This doesn’t mean that you can forget you had surgery you will need to continue to take special care of your back. It can take months for a surgical site to heal completely and depending on the extent of your tumor, surrounding tissues and structures may need some extra recovery time as well. Additional treatment may be needed if your tumor is cancerous. This treatment may include radiation and/or chemotherapy. If needed, it is important that you receive this treatment in a timely fashion after your surgeon has cleared you.
You can expect to see your surgeon regularly the frequency of check-ups will be determined by the doctor and your particular needs. Diagnostics such as X-rays or scans may be conducted to monitor healing and make sure there are no complications or delays. Your surgeon will make necessary recommendations for exercise or lifestyle changes if they see anything that indicates you’re not healing as they’d expect.
If you’re still seeing a physical therapist, continue your appointments. One of the biggest mistakes someone recovering from any type of surgery can make is to quit going to physical therapy because they feel better.
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One of the most important aspects of healing from a compression fracture is preventing re-injury. If you have surgery, you should always follow any instructions given by your surgeon and avoid any lifting or exercise for at least several weeks.
With surgery for a compression fracture, you will not be able to twist or bend your back for as much as 6 weeks following the surgery. That means that you will have to change the way that you do a lot of your normal activities of daily life, such as getting out of bed. Your surgeon may prescribe physical therapy to help you learn the correct and safe way to move throughout your day, so be sure to keep all of your physical therapy appointments and perform the recommended activities and exercises they ask you to do as well.
Anytime you move, remember that the goal is to keep the spine as straight and lengthened as possible, to avoid placing unnecessary strain on the back. It’s important that you always sit up as tall as you can so you don’t put additional pressure on the spine and that you do NOT bend over to get out of bed.
Instead, you should always follow your provider’s recommendations and use the following tips for getting out of bed with a compression fracture:
To get into bed, you’ll again want to try to keep your back as straight as possible, so you will lower yourself onto your side, using your arms for support. When turning, always move your head first, then your shoulders and hips at the same time (think of them as one unit working together) to avoid twisting your back.
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It may get worse when you sit or stand. It can make it hard to move or walk. Many people recall the exact moment the pain started and what they were doing at the time.
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Spinal compression fractures are the most common type of osteoporotic fractures. These vertebral fractures can permanently alter the shape and strength of the spine. The fractures usually heal on their own and the pain goes away. For the most part, nonoperative treatments are recommended for compression fracture. These treatments include pain medications and modified physical activity. The doctor may recommend wearing a brace that helps support the back and prevents bending forward, and therefore removes pressure from the fractured vertebrae.
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