Neurosurgical Services

Spinal & Brain Tumor Resection

Spinal tumors are similar to any other type of tumor. Their cause is unknown but they can occur as a primary tumor or as a result of the spread of cancer from another area. Tumors are masses of damaged cells that have multiplied and grown out of control. They may destroy nearby healthy cells or cause them to malfunction. A tumor that forms in the area of the spinal cord can upset the connection between the brain and the nerves or inhibit the cord’s blood supply. Spinal column tumors can cause symptoms on one or both sides of the body at once.

Spinal tumors can cause back pain, loss of sensation, muscle weakness and spasms. Like other tumors, these must be treated quickly and effectively so they do not spread to other areas. The majority of spinal cord tumors grow below the neck. The symptoms usually take place in the same region of the body or below that of where the tumor has formed. Extradural tumors are found between the inner portion of the spinal canal and the dura mater. Tumors within the dura may be found outside or inside the spinal cord.

The most common tumors that develop within the spinal cord are astrocytomas or ependymomas. Some tumors, such as schwannomas, neurofibromas, or meningiomas, may develop in the tissue around the spinal cord and nerves. The majority of these tumors are benign but because they often compress the nerves and cause pain, they usually need to be removed surgically.

Complete tumor resection is usually most effective in treating spinal tumors. Many spinal tumors are easy to remove because they do not form on the actual spinal cord. Others may be harder to remove because they cannot be distinguished from normal spinal tissue. Successful resection can relieve pain and significantly benefit the patient.

Surgery is performed under general anesthesia while the spinal cord is constantly monitored. The dura is opened to expose the spinal cord and nerves. The tumor is removed and a specimen is sent to a lab for analysis. These procedures may be followed by radiation therapy to ensure complete removal of the tumor.

After surgery, a hospital stay is usually required for several days. Bed rest is recommended to improve healing. Physical therapy or rehabilitation is often needed, and pain is managed with oral analgesics. Strenuous activity is prohibited until approved by your doctor.

Spinal Cysts

A cyst is a fluid-filled sac that can develop in the spine as a result of degeneration and can lead to spinal stenosis or other painful, serious conditions.

There are several different types of cysts that may develop within the spinal cord, although synovial cysts are most common. Synovial cysts develop within the facet joints as cartilage wears away and excess fluid is produced within the joint. The excess fluid is retained within synovium of the joint and forms a cyst. Other types of spinal cysts include arachnoid cysts, Tarlov cysts, extramedullary cysts and many more.

Symptoms of Spinal Cysts

Patients with a spinal cyst may not experience any symptoms if the cyst remains small and stable. As the cyst progresses and becomes more severe, it may cause pain in the back that travels down the legs as well, and can also lead to spinal stenosis, which may cause pain, cramping and numbness.

Spinal cysts tend to cause pain in certain positions, such as while standing or remaining still for prolonged periods of time. Many patients can reduce the severity of their symptoms by frequently changing positions or by adjusting their activities to remain in a seated position more often.

Treatment

Cysts that do not cause symptoms and do not seem to be growing at a rapid rate may not require any treatment other than regular monitoring of the condition. Patients that experience pain from their cyst may benefit from facet or epidural steroid injections that decrease inflammation and temporarily relieve pain. In some cases, the cyst may be joined through the same needle used for facet injections.

Cysts that cause significant pain and are growing in size may require surgery to effectively remove the cyst and prevent serious complications from occurring. Surgery to treat spinal cysts most commonly involves decompression with or without spine fusion surgery. This involves removing the cyst and then fusing the joint together to prevent the cyst from regenerating. Surgery is usually reserved for patients who wish to participate in physical activities with less pain.

It is important for patients to consider their treatment options by evaluating their own pain and discussing their options with an experienced doctor.

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Neurology | San Antonio | New Braunfels