Frequently, surgery is preceded by a CT guided embolization (of blood vessels supplying the tumor) to decrease blood loss during surgery. The spine surgery in these cases involves decompression of nerves, removal of tumor, sending material for biopsy, reconstructing the defect left behind after removing the tumor and fixing the spine with screws and rods made up of titanium.
Some cases with intractable metastasis related pain might be suitable for cement injection procedures (Kyphoplasty / Vertebroplasty). This percutaneous procedure is particularly suitable for these patients with multiple medical co-morbidities as general anesthesia; open surgery and blood loss can be avoided. The procedure involves injecting cement in the spinal bone under the guidance of an X-ray. The injected cement gives immediate structural support to the spinal bone involved by the cancer, thereby relieving pain.
Lesions of the spine such as Osteoid osteoma, Osteoblastoma, Aneurysmal Bone Cyst, Giant cell tumor and Chondrosarcoma always need surgery. For primary and secondary cancers (metastasis) of the spine, chemotherapy and radiotherapy form the mainstay of treatment. Surgery is required for:
- Obtaining material for biopsy in case of unknown lesions.
- Relieving pressure on the spinal cord
- Intractable pain
- Severe destruction of spinal bones
