Spinal tumors are a fairly rare disease. The most common symptom in patients with a spinal tumor is back pain. However, back pain occurs in other more common diseases of the spine and internal organs. As a result, most patients are initially treated stubbornly for osteochondrosis or pelvic inflammatory diseases, and they get to the neurosurgeon in Delhi in the late stages of the disease, when the tumor has reached a large size. This problem exists in all countries of the world. Unfortunately, there is no promising spinal tumor treatment in Delhi to solve it today.
CAUSES
Currently, there is no unified scientific theory explaining the causes of the development of tumors in the body. It was shown that such harmful factors as smoking, ionizing radiation, some chemical compounds, excessive insolation, burdened heredity increase the risk of developing malignant tumors. A spinal tumor may be primary; in this case, tumor cells are formed directly in the structures of the spinal column. However, more often in clinical practice, a spine is affected by a malignant tumor as a result of metastasis or progressive growth of a tumor of the internal organs with sprouting of the spinal column. The vertebral bodies have a good blood supply and a branched vasculature, so cancer cells can be transported with a blood stream and settle in the vessels of the vertebrae.
SYMPTOMS
In more than 80% of patients with a spinal tumor, the first symptom is pain. At the same time, the pain tends to progress, despite conservative treatment, and in some patients is accompanied by weakness and a decrease in appetite. In many cases, the pain intensifies at night, although in other patients there is no dependence of the severity of pain on the time of day and the degree of physical activity. With an increase in the size of the tumor, damage to the nerve structures occurs, which is manifested by a violation of the function of the pelvic organs, numbness and a decrease in strength in the limbs, as well as acute shooting pain in the arms or legs.
Diagnosis of a spinal tumor begins with a detailed questioning of the patient about his complaints, the duration of the disease, the effectiveness of the treatment. After collecting an anamnesis and medical history, the spine surgeon in Delhi conducts a physical examination of the patient, including examination, palpation, checking sensitivity, muscle strength, reflexes and tension symptoms of nerve roots.
If a spinal tumor is suspected, additional laboratory and instrumental examination methods are necessary. A routine examination method is radiography of the spine, which allows you to diagnose most of the spinal tumors. However, this method, proven over the years, is not without drawbacks, since in many cases, changes in radiographs appear already in the late stages of the disease. And tumors of soft tissues (for example, the spinal cord) may not be visualized at all on x-rays. Therefore, in many cases, an accurate diagnosis also requires computed tomography, magnetic resonance imaging and radioisotope scanning.
TREATMENT
THE CHOICE OF SPINAL TUMOR TREATMENT IN DELHI TACTICS DEPENDS ON THE MORPHOLOGICAL TYPE OF THE TUMOR, ITS SIZE AND LOCATION. TUMORS ARE DIVIDED INTO BENIGN AND MALIGNANT.
The term “benign” is used in relation to tumors that do not have the ability to infiltrate growth, have a capsule, do not metastasize, do not lead to systemic changes in the patient’s body. Benign tumors are quite easily cured by spinal tumor surgery in Delhi. Malignant tumors, on the contrary, have the ability to infiltrate growth, metastasis and, developing, cause general changes in the body (weight loss, weakness, lack of appetite). In advanced cases, a malignant tumor leads to the death of the patient.
BENIGN TUMORS
OSTEOID OSTEOMA
As a rule, this type of benign tumor is found in young people. Osteoid osteoma accounts for approximately 10% of all spinal tumors. In most cases, this tumor affects the posterior structures of the vertebra. In typical cases, the disease manifests itself as severe back pain, which intensifies at night. Aspirin and non-steroidal anti-inflammatory drugs have a pronounced analgesic effect. An osteoid osteoma can be poorly visualized on x-rays; however, computed tomography can detect even a small tumor. The spinal tumor treatment in Delhi consists of surgical removal of the tumor. Recently, radiofrequency ablation (destruction) of the tumor has been increasingly used in clinical practice. This minimally invasive intervention consists in introducing into the tumor node under fluoroscopic control a special probe through which a high-frequency current is supplied. As a result, the probe warms up and thermal destruction of the tumor. The forecast is favourable. In most cases, surgical treatment leads to a complete cure.
OSTEOBLASTOMA
Osteoblastoma is called an osteoid osteoma, which reached a diameter of 2 centimetres or more. It manifests itself in the same way as the “younger sister” with back pain. With osteoblastoma, surgery is indicated. The risk of relapse after removal of the tumor is approximately 10%.
GIANT CELL TUMOR
This type of tumor can be considered as a “borderline” between benign and malignant tumors. It does not have the ability to metastasize, but in advanced cases it can germinate in other organs and tissues. In most cases, a giant cell tumor affects the anterior vertebrae (vertebral body). Most often, this type of tumor occurs in people aged 20-40 years, however, cases of the disease in children and in the elderly are described. Surgical treatment consists in the removal of the tumor within healthy tissues (extended resection). In some cases, before spinal tumor surgery in Delhi, a course of radiation or chemotherapy is performed to reduce the risk of a relapse of the disease.
EOSINOPHILIC GRANULOMA
It is not a true tumor, but damage to bone tissue by active eosinophils – a population of white blood cells that migrate from the bloodstream and form a focal accumulation (infiltrate). The formation of an eosinophilic granuloma is often noted not only in the vertebrae, but also in other tissues and organs. This disease is called eosinophilic granulomatosis. Granuloma leads to the destruction of the vertebral body, which is often complicated by the development of a compression fracture. The approach to the treatment of patients with eosinophilic granuloma is individual. In many cases, drug therapy or radiation therapy is effective. With the development of a complicated fracture, the question arises of the need for surgical intervention.
ENCHONDROMA
This benign tumor of the cartilage with an increase in size can lead to compression of the spinal cord or nerve roots. Rare cases of degeneration of the enchondroma into a malignant tumor called chondrosarcoma are described.
HEMANGIOMA
Hemangioma is a benign tumor that affects the vertebral bodies. This tumor is also found in other organs and tissues: liver, skin, brain, etc. In the spine, hemangioma most often develops in the lower thoracic and upper lumbar vertebrae, and, as a rule, one vertebra is involved in the process. This type of tumor is found mainly in middle-aged people. Women get sick more often than men. Hemangiomas in some patients for many years and even decades have not been clinically manifested.
The most characteristic symptom of hemangioma is pain. As a rule, pain appears when a tumor node reaches a large size and affects almost the entire vertebral body. On the radiograph, the hemangioma looks like a cellular structure, reminiscent of the structure of a honeycomb. In this case, a decrease in the height of the vertebral body due to a compression fracture may be noted. With a significant decrease in vertebral body height, compression of the spinal cord or nerve root develops, which is manifested by pain, numbness and weakness in the lower extremities, pelvic disorders.
In determining treatment tactics, the neurosurgeon in Delhi takes into account data such as the presence or absence of symptoms, complications, as well as the size of the tumor. With an asymptomatic course of the disease, with a small tumor, a dynamic observation is performed. Surgical treatment for spinal tumor surgery in Delhi is indicated in the case of complications, severe pain. Currently, low-invasive surgery called vertebroplasty is widely used to treat patients with vertebral hemangioma. This operation is carried out under local anaesthesia and allows you to relieve the patient from back pain that tormented him a few hours after the intervention.
MALIGNANT TUMORS
CANCER METASTASES
The vertebral column has a rich blood supply, and the venous plexus of the spine is closely connected with the veins of the pelvis, abdominal and thoracic cavities. For this reason, there is a tendency to metastasis to the spine of malignant tumors of the internal organs. In most cases, metastases occur already in the late, advanced stages of the disease. Spinal metastases are manifested by back pain. With an increase in the size of the tumor nodes, compression of the spinal cord or nerve roots may occur. To date, there are no methods for the radical cure of metastases of malignant tumors in the spine. With compression of the nerve structures, with the development of a pathological fracture, a decompression-stabilizing operation is performed. Conservative treatment is aimed at reducing pain,
MYELOMA (PLASMACYTOMA)
This is the most common primary malignant bone tumor. Most often, plasmacytoma affects people older than 40 years. This tumor tends to generalize, while other bones are involved in the process. In this case, the disease is called myeloma. Palliative treatment consists in taking chemotherapeutic drugs. Modern therapy allows for many years to control the course of the disease, which allows patients to lead a normal lifestyle. With the development of complications, such as a pathological fracture of the spine or compression of nerve structures, surgery may be indicated.
OSTEOSARCOMA
Osteosarcoma ranks second in frequency among primary malignant bone tumors. Most often, this disease occurs in children and adolescents, as well as in the elderly. Modern combination antitumor therapy (surgery and chemotherapy) allows achieving 5-year survival in more than 80% of patients. This is a great achievement of oncology, since as early as 20 years ago all patients with osteosarcoma were doomed to death.
CHORDOMA
Although chordoma can occur in any part of the spinal column, the most favourite places for the location of this tumor are the 1st cervical vertebra and the lumbosacral spine. This is a fairly rare disease. Most often, chordoma occurs in middle-aged men. According to x-ray, computed tomography, magnetic resonance imaging, only a preliminary diagnosis can be made. To confirm the diagnosis, a biopsy is necessary (taking a piece of tumor tissue with microscopic examination). Surgical treatment. The prognosis depends on the size of the tumor, the presence of complications and the general condition of the patient.