Based on the plane & relation of tumor to spinal cord & dura, they are classified as
- intra medullary- Astrocytoma, Ependymoma, Hemangioblastoma.
- Intradural extra medullary- meningioma, neurofibroma.
- Extradural- vertebral hemangioma, bony tumors of spine.
Pain may be local or have a segmental distribution. Sensory disturbances, tightness in limbs with weakness of limbs. Bladder & bowel disturbances & impotence.
MRI with contrast delineates the extent of tumor & its relationship to the spinal cord. CT scan of spine with 3D reconstruction is helpful in bony tumors of spine.
Laminectomy (removal of laminae & spinous process) exposing the proximal & distal extents of the tumor. In children & in long segment tumors, Laminotomy is done in which the posterior element(ligaments, laminae, spinous processes)s are repositioned.
Midline dural opening, use of microscope to magnify the surgical field & use of CUSA to debulk the tumor prior to dissection & mobilization of tumor from the spinal cord.
Incision on the spinal cord in intra medullary tumors is done at the midline of the cord & extends to the entire extent of the tumor.
After the spinal tumor is removed,the dura is closed or a dural substitute is used to close the opening.
Apollo Brain & Spine care centre has the infrastructure with spinal cord monitoring & trained surgeons to handle spinal cord tumors & deliver optimal results.