This special arm of spinal surgery is playing an ever bigger part in this institution. The reasons for this are: the developments of new surgical techniques make more tumors operable and, in conjunction with oncologic treatments, curable, and the number of tumorous diseases is on the increase worldwide.
We differentiate between benign and malignant tumors and between primary tumors, that originate in the spine, and secondary tumors, that originally began growing in another organ and spread to the spine to become a spinal tumor.
Benign tumors do not metastasize, thus, it is understandable that they should appear alone (i.e., soliter tumors). These tumors do not affect a person's life span but may have an effect on the quality of life (i.e., pain, paralysis, etc.). Removal is not always necessary.
Spinal tumors that are malignant may be primary and metastatic. In general, a soliter primary tumor has a good chance of complete removal if operated in time. A primary malignant tumor may, of course, also metastasize into other organs (i.e., lungs, liver, etc.) in which case surgical intervention alone would not be sufficient but would require oncological treatment, as well.
In the case of malignant metastatic spinal tumors the biopsy results, the type and number of organs involved and the magnitude of the metastasis determines the state of the disease and whether any surgical intervention is to be done. In such cases, the surgeon is often forced to keep from operating a Patient when the outlook is hopeless since the length of the life span cannot be altered and the quality of life improved.
The treatment of soliter metastases is equal to that of the primary tumors.
At times, in cases that are not diagnosable, we might take biopsy samples to aid oncologic treatments even though there might be no further necessity or reason for surgical care.
Beside the complete resection of a tumor through radical surgery, decompression (pressure alleviating surgery) is also possible wherein only the spine segment involved is stabilized with appropriate fixation. When combining these methods, the missing tissue, due to the tumor, often has to be replaced with bone cement or special spacers. This surgery may be applied on a wide scale from the excision of very painful minuscule tumors to tumors the size of a human head involving the pelvic and sacral area and require complete reconstruction.
We have successfully performed quite a number of total segment resections and replacements thereby restoring the three functions of the spine. With no external fixation required and the anterior spine's weight bearing capability restored, the patient may get out of bed the following day and, since the short and very stable bridging internal fixation only sacrifices a few motion segments, the spine segment will not only be weight bearing but will regain most of its motion capability as the pain quickly decreases.