Tumors from the cervical region that were previously thought unoperable can now be handled with ease. Thanks to the novel technique developed by surgeons at the USCF institute.
The technique uses advances in spinal instrumentation and reconstructive strategies to provide a direct approach to the removal of cervical spinal tumors with minimal, or no, neural manipulation. The technique involves a lateral paramedian transpedicular approach that confers a superior exposure area.
AdvertisementThe technique has been developed by neurosurgeon Christopher Ames, MD, co-director of neurospinal disorders and director of the Spinal Biomechanics and Spinal Neuronavigation Laboratory at UCSF Medical Center. The technique is particularly useful in cases in where the tumor is located in the middle of the spinal canal and attached to the lining of the spine. These types of tumors include meningiomas, neurofibromas and exophytic astrocytomas.
Neurofibromas can occur as a sporadic condition or as a genetic disorder such as neurofibromatosis. While a common type of spinal tumor, neurofibromas are challenging lesions to approach surgically. Found at the base of the skull on or near the spine, the tumors often sit just below the brain stem and press against the spinal cord as they grow. Some other tumors involve several regions of the vertebrae. In some cases, it can exert pressure against the spinal cord causing pain, numbness and loss of mobility in the hands, arms and legs. The patient can even become paralyzed if left untreated.
Most of the surgeons are reluctant to perform surgery for such cases because of the proximity to sensitive anatomy including the spinal cord, pharynx, nerves, and major blood vessels and the risk of irreversible nerve damage, paralysis and even death.
The first approach in the surgical technique is the use of standard and innovative devices to first remove and then reconstruct portions of the cervical spine in order to access tumors.
Once this is accomplished and the bone is removed, surgeons can have a direct line of sight to the tumor. This would enable them to remove the entire tumor without the necessity of moving or manipulating spinal cord. Following removal of the tumor, surgeons can rebuild the spine with artificial pedicle screws.
The neurosurgeon behind this novel innovation specializes in spinal reconstructive surgery for trauma, tumors and degenerative disease, and intends to develop new techniques for computer-guided, minimally invasive instrumentation and development of resorbable materials for spine stabilization and growth factor delivery.
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