Treatment Options

Chapter 13 - Management of Spinal Tumours

Skeleton tumours of the spine have an incidence of only 0.4% of all neoplasms. Benign lesions occur in younger patients. Malignancy is associated with older age.

The origin, biological behaviour and preferred treatment options of common primary extradural tumours of the spine are shown in the table.

Medical treatment, radiotherapy, radiosurgery, vertebral augmentation, decompression and spinal fusion alone or in combination are the treatment options.

Intradural-extramedullary tumours (mostly neuroma or meningioma) have to be treated surgically in case of neurological deficit or documented growth.

Surgical steps: Complete extirpation of a spinal neuroma, which is mostly possible.

Adjuvant treatment is generally not required.

Intramedullary tumours have to be treated in case of manifest or imminent neurological impairment, which is mostly the case.

Surgical steps: Identifying the dorsal spinal cord midline, myelotomy, preparing the lesion and identifying the borders to healthy tissue, removing the prepared lesion and pial suturing of spinal cord.

Incompletely resected tumours are treated by dural extension plastic and adjuvant expansion therapies, adapted from intrinsic cerebral gliomas.

Revision Questions

  1. What is the incidence of skeleton tumours of the spine?
  2. What is the indication to treat intradural-extramedullary spinal cord lesions?
  3. Where is the typical dorsal myelotomy approach located?

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Last update: 18 September 2017