Spinal Oncology
About Spine Tumors
Spine tumors are classified as either primary (benign or malignant) or secondary (metastatic) tumors. The spine is one of the most common places in the body for the spread (metastasis) of cancer. Each year, an estimated 18,000 people in the U.S. are diagnosed with metastatic spine disease. More than 40% of all patients who have cancer elsewhere in their body, including breast, lung, prostate, thyroid, renal and colon, will experience the spread of their cancer to their spine in their lifetime.
Spinal tumors can occur inside the spinal cord itself (intradural, intramedullary) or inside the dura (tough covering over the spinal cord) but outside of the spinal cord (intradural, extramedullary). Tumor growth can lead to a pathological fracture, spinal cord or nerve root compression. The goal of treatment is to remove the tumor, preserve or improve neurological function, provide pain relief and structural stability.
Diagnosis
The most common symptom of a spine tumor is pain. The pain tends to be progressive. Symptoms may result from bone and soft tissue invasion, spinal instability, or pressure on the spinal cord and/or nerves. Signs include numbness or abnormal sensations in the arms or legs, weakness of the arms or legs and/or loss of bowel or bladder control. Imaging studies are used to determine the presence and extent of spinal lesions. These studies may include X-rays, CT, MRI and PET scans, and myelograms.
Interdisciplinary Team Approach to Spine Tumor Treatment
Dr. Frank Vrionis is the Director of Complex Spine Surgery and Skull Base Surgery, in the Department of Neuro Oncology at Moffitt. The interdisciplinary team includes: neurosurgeons, neuro oncologists, radiation oncologists, neuroradiologists, neuropathologists, nurses, nurse practitioners, physician assistants, neuropsychologists, physical therapists, social workers, pharmacists, and case managers.
A weekly tumor conference provides an opportunity to discuss every patient under our care. After evaluation of clinical reports, radiology studies and pathology materials, recommendations are made for therapeutic options for each patient. These may include surgery, radiation therapy, and standard or investigational chemotherapies. This interdisciplinary approach leads to highly coordinated, expert quality patient care and superior patient satisfaction.
We offer our patients state-of-the-art spinal stabilization for metastatic spine tumors to preserve neural function and improve quality of life. We emphasize minimally invasive techniques, such as retropleural thoracotomies, short segment fusions and the use of cages, to enhance fusion. For tumors of the spinal cord, we emphasize intraoperative monitoring and stimulation of the spinal cord to maximize the safety of the resection.
Procedures such as kyphoplasty and vertebroplasty are available to reconstruct compressed vertebral bone, restore alignment or remove pressure on a nerve. Technically, the main concerns in the treatment of a spinal metastasis are to preserve mechanical and neurologic function. The early diagnosis and treatment of spinal cord tumors are essential in reducing pain, preserving or improving neurological function and improving quality of life.
Some of our treatments include:
Spine Tumors
- En bloc resections for Pancoast and primary spine tumors (chordomas, chondrosarcomas)
- Multilevel anterior and/or posterior tumor resection with spinal stabilization for metastatic tumors to the spine at any level (C1 to sacrum)
- Resection of intramedullary (ependymomas, astrocytomas, hemangioblastomas) or extramedullary spinal cord tumors (meningiomas, schwannomas)
Degenerative
- Minimally invasive lumbar and cervical discectomies
- Minimally invasive lumbar interbody fusions (posterior, lateral)
- Percutaneous lumbar instrumentation
- Surgery for degenerative lumbar scoliotic deformities
- Minimally invasive sacroiliac fusions
Non-surgical Treatment or Additional Therapies
- Bisphosphonate treatments
- Radiation
- Chemotherapy
Patient Information
- Benign and Malignant Spine Tumors
- Surgical Procedures
- Discharge Instructions
- Patient Resources
- Interactive Animated Videos