Spine Disorders

Spinal Tumours

Indications For Surgery In Spinal Tumors:

  • Diagnosis [?]
  • “Severe” Unbearable, Uncontrolled “Rest Pain”
  • Progressive-Significant Neural Compression [Cord-Conus-Cauda]
  • Postoperative Instabilities and Deformities [Viz: Growing Spines]

Types of Bony Spinal Tumors

A. Benign Tumors

With No Risk of Spread / Recurrence [Aneurysmal Bone Cyst-Osteochondroma - Osteoid Osteoma]

L3 : OSTEOID OSTEOMA IN 18 year old : Surgical EXCISION

No adjuvant (Chemotherapy or Radiotherapy) needed Generally

B. Locally Aggressive Tumors With Potential For Recurrence And/Or Malignant Conversion-Spread

[Giantcelltumors -Solitary Plasmacytomas]

Sx: Meticulous Resection-Reconstruction With Back Up Therapy [Chemotherapy/Radiotherapy]

C. Highly Malignant Tumors With Spread Or Local Invasion

[Multiple Myeloma Osteosarcomas]

Highly Malignant Tumors With Spread Or Local Invasion [Multiple Myeloma-Osteosarcomas]

Sx: Palliative Surgery For Immedeate Stabilty And Cord Decompression To Reduce Tumor Load And Improve Quality Of Life [Back Up Ct/Rt]

Though The Need For Surgery In This Group Has Reduced Over The Years

D. Metastasis


  • Metastatic spine tumours – not rare !
  • Impairs – pt s function and ADL
  • Choice and decision making in treatment protocols of spine mets is the key !!
  • ‘Local control of disease’ and alleviation of “pain and paralysis” leading to improved ADL is the hallmark of surgical intervention!!
  • Surgery is extensive and morbid , hence general condition and life expectancy are significant indices for decision making !!
  • Adequate choice of procedure – is the key in any intervention !!
  • Efficacy of adjuvant therapy in the primary pathology alters surgical decision making !!
  • A Multi Disciplinary Approach is always warranted !!
  • Factors Determining The eventual Plan of treatment
    • Pathology and extent of disease
    • Sensitivity to adjuvant therapy
    • Pt s general condition
    • Expected survival
    • Co morbidities
    • Age
    • Availability of resources