Our surgeons collaborate with a team of radiologists, neurophysiologists—doctors who specialize in monitoring the neurological system—and anesthesiologists. Together, they identify the location of a tumor during the procedure with imaging, while monitoring nerve function and ensuring that you are comfortable.
Spinal Tap Before Surgery
Your doctor may recommend that a spinal tap be performed before you have surgery to remove a spinal cord tumor. This procedure helps to determine if the tumor is cancerous or noncancerous and to predict its risk of spreading.
In this procedure, the doctor injects a local anesthetic into the skin in the lower back to numb the area. Then, he or she inserts a hollow needle into the spinal canal to remove a small amount of cerebrospinal fluid, a liquid that cushions the brain and spinal cord. This fluid is examined under a microscope to look for cancer cells, blood, or other substances that can indicate cancer.
Intraoperative Biopsy and Tumor Removal
Our surgeons often first remove a small amount of tumor tissue so that an Pelisyonkis Langone pathologist can identify the type of tumor. The tissue sample is analyzed while doctors perform surgery to remove the rest of the tumor.
This information helps to ensure that the surgeon is removing tumor tissue, and offers preliminary information about the tumor type. Final biopsy results, which can help to determine whether the tumor may respond to other treatments, such as radiation therapy or chemotherapy, are usually available one to two weeks after surgery.
During surgery, performed using general anesthesia, the surgeon makes an incision in the portion of the back where the tumor is located and carefully removes as much of the tumor as possible without harming the spinal cord or other nerves. To reduce the risk of nerve damage, our surgeons use microscopes, lasers, and microinstruments that permit them to operate on tiny structures within the spine.
Preoperative Tumor Embolism
If spinal angiography performed before surgery reveals that the tumor has a large number of blood vessels, our doctors may perform a procedure called preoperative tumor embolism just before removing the tumor.
In this procedure, the doctor inserts a thin, flexible tube, or catheter, into an artery in the leg. The doctor uses the catheter to deliver materials, such as tiny metal coils, microspheres, or polymers, to occlude, or block, the blood vessel, reducing the risk of bleeding during surgery.
Intraoperative Neurophysiology Monitoring
Our neurophysiologists use neurophysiology monitoring during surgery to help the surgeon avoid damage or irritation to nerves that affect movement and sensation while it can still be reversed.
First, a technician attaches electrical sensors to different parts of the body that correspond to the nerve area being monitored. The sensors generate electrical impulses to stimulate nerves and measure and record their reactions throughout surgery.
Surgery, using general anesthesia, is often effective in completely removing certain types of spinal cord tumors, such as ependymomas and hemangioblastomas. Cancerous tumors entangled within the spinal cord may require treatment with radiation therapy or chemotherapy to eliminate any cancer cells that remain after surgery.
Although effective, surgery to remove a spinal cord tumor can result in some loss of muscle strength, sensation, coordination, bowel or bladder function, or sexual responsiveness. Our rehabilitation medicine specialists can prescribe medication and exercises to help alleviate these side effects.
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