Spinal Tumour Resection
Spinal tumour resection is the surgical removal or debulking of benign or malignant abnormal growths within the spinal canal, bones, or protective membranes. Performed using high-powered surgical microscopes, micro-dissection tools, and continuous neurological monitoring, the primary goals are to decompress the spinal cord and nerves, preserve stability, and obtain a tissue diagnosis.
When this procedure may be recommended
- Primary benign tumours of the spinal cord or nerve roots (meningiomas, schwannomas, ependymomas).
- Metastatic spinal tumours compressing the spinal cord and causing neurological deficits.
- Tumours causing severe, unremitting pain or spinal instability.
- Rapidly progressive neurological weakness, sensory loss, or gait difficulty.
Who may be a candidate
Candidacy is determined by the tumour type, location, extent of spinal cord compression, the patient's overall health, and oncological prognosis. Microsurgery is highly beneficial for well-demarcated benign tumours, while metastatic lesions may require a combination of surgery and radiation.
Advanced medical implant technology (no text). Alternatives to surgery
- Stereotactic radiosurgery (focused radiation) for small, deep, or medically inoperable tumours.
- Systemic therapies including chemotherapy or immunotherapy.
- Palliative radiotherapy and corticosteroid therapy to manage swelling.
What to expect
- Access: A midline incision is made over the affected spinal level under general anaesthesia.
- Decompression: A laminectomy is performed to open the spinal canal and expose the protective dura membrane.
- Dural Opening (for intradural tumours): The dura is carefully opened, exposing the spinal cord and nerve roots under the operating microscope.
- Micro-Resection: Microsurgical dissection tools and ultrasonic aspirators are used to carefully separate and remove the tumour from nerve tissues.
- Stabilisation (if needed): Spinal screws and rods are secured if the bone removal threatens spinal stability.
- Closure: The dura is closed water-tightly, and the muscle and skin layers are sutured closed.
Technology and imaging
Employs high-magnification operating microscopes, intraoperative neuromonitoring (SSEP/MEP), ultrasonic bone scalpels, and surgical navigation.
High-precision diagnostic imaging visualization. 
Clinical Zeiss/Leica operating microscope setup. Hospital stay
Typically 3 to 5 nights in hospital, often including a night in the ICU or HDU for monitoring.
Recovery milestones
- Day 1: Patient is monitored closely. Neurological checks are performed hourly.
- Days 2-4: Progressive mobilisation with physical therapy, wound drain removal, and supportive care.
- Weeks 1-6: Home recovery. Avoid bending, lifting, or twisting. Stitches or staples are removed at 10-14 days.
- Oncology Pacing: Tissue pathology results guide the need for post-operative radiotherapy or systemic cancer care.
Post-operative mobilization and recovery milestones. Risks and complications
- New or worsened neurological deficits (weakness, sensory loss, bowel/bladder changes).
- Cerebrospinal fluid leak due to duraplasty (2% to 4% risk).
- Infection of the spinal canal or bone flap.
- Spinal instability requiring future fusion.
Frequently asked questions
What is the goal of surgery for metastatic spinal tumours?
For metastatic cancers that have spread to the spine, the primary goal is palliative: to relieve spinal cord compression, prevent permanent paralysis, reduce pain, and restore spinal stability, allowing the patient to undergo further radiation or chemotherapy.