Professor MD Thomas Gösling
Removing of malignant tumor on the spine is complex procedure which is provided by the combined efforts of spine surgeons and cancer specialists of Clinic of Braunschweig.
Primary cancer in spine is quite rare; mostly backbone malignant tumors are of metastatic origin.
Primary cancer of spine, as a rule, develops in the vertebral column. The most common malignant tumor of the spine is osteogenic sarcoma. Osteosarcoma is bone cancer that usually occurs in children and younger adult patients and, if slow growing, has good chances to be cured when diagnosed early. One of specific symptom of osteosarcoma is sudden fracture. The main treatment for this type of tumor is surgery though it can recur and need repeated treatment.
Spinal Lymphona is another cancerous neoplasm which is blood cell malignant tumor that is mostly found in vertebral body but rarely can appear in interdural layer. In severe stage it creates significant compression to the spinal cord and requires surgery.
Chordoma is a type of malignant tumor that is found in spine or skull. It is believed to derive from notochord, embryonic remnants of material similar to cartilage. Chordome is probably has genetic origin. Chordoma tends to regenerate after treatment. Mostly it is located in cranial of sacrum (lower back) region and has lesser development in cervical, thoracic or lumbar spine.
Chondrosarcoma is a type of skeletal cancer that affects any age category of people. It arises from cartilage cells. It is mostly develops in pelvis or shoulder region. When it occurs in lumbar spine it may cause such symptoms as back and thigh pain or sciatica.
Glioblastoma is a rare primary cancer in spine but hardly curable. 5-years survival rate is from 17% in younger (till 44 year) people to 4 % in patients older than 55.
Metastases are spread to the spinal column from the other malignant lesions in the body. The spine is third of possible locations of metastatic tumors and 70% of all osseous metastases are in spine. In women, the primary origin of malignant tumor is breast cancer, while in men the initial cause of spreading metastases is lung or prostate cancer.
Often metastatic spine cancer may be asymptomatic. In severe stage it is characterized with focal pain that does not become better with rest and system health disorders as weight loss, nausea, vomiting, fever and other symptoms that indicate serious system disorder. For disseminated malignant tumors surgery is rarely considered.
Open surgery is applied for removing of localized primary cancerous tumors of the spine. The optimal approach is chosen depending on tumor location and its size.
The most difficult region for spine tumor surgery is upper thoracic which is difficultly reachable both from anterior and posterior approach. Cervical spine malignant tumor usually removed via posterolateral approach that means access in performed from the back and from the side. Anterolateral surgery is also possible but rarer.
In case of metastatic cancer tumors, only a limited range of patients meeting certain criteria is eligible for open surgery as those who:
Those patients with metastatic spinal cancer primary who have primary breast cancer or thyroid cancer show the best rate of success especially when the tumor is slow-developing. The operation has a few goals as removing of the tumor, stabilizing of the spine and avoiding of possible neurological issues.
With development of minimally invasive surgical techniques new approach to treatment of malignant back tumors has appeared. Combination of chemotherapy or radiotherapy with endoscopic surgery is growing popular. While open surgery often is not effective for metastatic cancer, minimally invasive method allows removing smaller parts of the tumors preserving the healthy tissues as much as possible. During the procedure intervention is performed trough smaller cut and controlled with special camera (endoscope) on the monitor. When surgery is followed with radiological or chemical treatment it gives better chances for complete cure.
Robotic spine surgery is similar to conventional minimally invasive treatment but operation is performed by robotized devices controlled by surgeon with computer. It allows high accuracy in performing manipulations with smaller lesions or virtuous work on nerves and vessel that are especially sensitive and easily can be damaged during surgery. This procedure required high skill from the surgeon.
In younger patients survival rate for malignant tumor disease of spine is quite high (up to 91-92%) excluding rare types of tumors as glioblastoma or anaplastic astrocytoma. With age it is decreases but patients still have good chances to cure.
If you need individual consultation on malignant spine tumor removal please apply online. Spine Center of Clinic of Braunschweig one of the newest and best in Germany offering comprehensive diagnosis and treatment service with involvement of cancer specialists and experienced surgeons.