When Does a Spinal Tumor Require Surgical Treatment?

When it comes to spinal tumors, about 97% are secondary tumors, meaning they come from a cancer that has metastasized from another site and spread to the spine. That means about 3% of spinal tumors are primary tumors, which are those that begin in the spine.

One of the biggest questions when it comes to spinal tumors is deciding whether — or more often, when — surgery is needed.

Fellowship-trained neurosurgical oncologist Jose Valerio, MD, understands the complexities involved in spinal tumors and spinal tumor surgery. In this blog, he discusses when surgery is typically recommended.   

A short tutorial on spinal tumors 

Spinal tumors are abnormal cell masses that develop in the spine. These growths can be noncancerous (benign) or cancerous (malignant), and can appear:

• On the bony spinal column (vertebrae)
• Along the central nerve network inside the spinal column (spinal cord)
• Within the protective tissues surrounding the spinal cord (meninges)

Spinal tumors are often diagnosed following an in-depth evaluation of a mixed set of nonspecific symptoms, such as chronic back pain, radiating leg or arm pain, and muscle weakness or stiffness. Spinal tumors are also discovered before they cause symptoms, often during an evaluation for another medical issue.    

Although a tumor can occur in any region of the spine, they appear most often in the lower back (lumbar spine) and upper to mid-back area (thoracic spine). Most primary spinal tumors are benign, while all secondary spinal tumors are cancerous. 

Spinal tumor treatment options 

Ideally, the objective of spinal tumor treatment is to eliminate the tumor. This goal can be complicated, however, by the tumor’s type, location, and the risk of causing permanent damage to the spinal cord and surrounding nerves in the treatment process.  

Watchful waiting 

For small, benign spinal tumors that aren’t causing disruptive symptoms and don’t appear to be progressing, Dr. Valerio may recommend holding off on surgery and taking a “watchful waiting” approach. 

This means using regular MRI scans to monitor the tumor for changes, and, in some cases, seeing if it responds to radiation or chemotherapy. 

Palliative care 

For patients with secondary, metastatic spinal tumors, treatment is usually palliative. The goal of this approach is to stabilize the spine, restore or preserve neurological function, and alleviate pain and other symptoms. Radiation or chemotherapy may also be an option in some cases.  

Surgical removal  

Surgery is often the best option for a spinal tumor, if not early on, then eventually. Some spinal tumors resist chemotherapy and radiation, and some are large, growing, or pressing on nerves and causing pain and other health issues.

Surgery is usually the treatment of choice if a problematic spinal tumor can be removed with little risk of causing injury to the spinal cord and nerves. High-precision tools, advanced monitoring, and cutting-edge surgical techniques make it possible for Dr. Valerio to access spinal tumors in less invasive ways than ever before.  

This means that spinal tumors that were considered inoperable just a decade ago can often be successfully removed today with a low risk for damage.  

When tumor removal is advised 

For patients with secondary spinal tumors, surgery is only considered an option if the tumor is resistant to radiation and chemotherapy, and if the patient is expected to live at least 3-4 months or longer.  

For patients with primary spinal tumors, surgery is usually advised when the tumor is: 

• Large, unstable, or growing 
• Causing significant symptoms
• Projected to cause problems

While there’s always at least a small risk for spinal damage during surgery, it’s increasingly rare for these surgeries to cause serious complications, such as paralysis. 

There is, on the other hand, a high chance for a catastrophic nerve or spinal injury if a patient opts out of spinal surgery and the tumor continues to grow. Besides the high probability of chronic pain, muscle weakness, and eventual paralysis, leaving a spinal tumor untreated can increase the risk for blood clots and other serious health complications. 

The bottom line? Dr. Valerio aims to remove these tumors at the right time. This often means taking a conservative approach in the beginning and getting more aggressive when the tumor clearly requires a definitive solution. 

To learn more about spine tumor treatment, contact the practice of Jose Valerio, MD, to book an appointment. We have offices in South Miami, Hialeah, and Weston, Florida.