Spinal Cord Tumor: Symptoms and Treatements
Friday, July 24, 2009
In general tumour is an abnormal mass of tissue due to abnormal division and growth of cells. Tumour does not connote cancer. Spinal cord is the continuation of the brainstem downwards from the junction of the head and neck down to the lower back.
Spinal cord can be compressed by lesions/tumours that arise from the covering layers (dura/arachnoid) or by tumours within spinal cord per se.
Based on the location spinal cord tumors are generally called
- Extradural (outside the dura)-they constitute about 80% of tumours
- Intradural Extramedullary (inside the dura but outside the cord)-this group amounts to about 15%
- Intramedullary (from within the spinal cord) accounts for the remaining 5%
The occurrence of spinal cord tumors is generally rare and it can leave a patient with neurological damage resulting in physical disabilities due to the pressure exerted by the tumour on the spinal cord. Early diagnosis and effective treatment is the key to the successful treatment and recovery without physical disability.
The Symptoms of Spinal cord Tumour depends on the type of tumor and its location. In almost all kinds of tumor ,pain is a common early feature that often precedes the onset of any neurological disturbance. Some of the common symptoms include: Pain in the back of neck and radiating to upper limbs or pain radiating around chest wall.
- Forward or backward neck movement causing ‘electric shock’ or tingling radiating down through the body to the extremities.
- Loss or disturbance of sensation to touch/pain/heat in the upper/lower extremities or trunk.
- Lower back pain ,shooting pain that runs down the legs
- Distinct muscular weakness causing falls/limp due to weakness in legs or difficulty in writing/doing work that involves fine movements of hand/fingers.
- In the advanced stage the bladder and the bowel functions will be affected.
The exact cause of Spinal cord Tumour is still a subject of discussion. Many researches have attributed the cause to genetic factors.In developmental/congenital disorders it is observed that tumours generally develop from the arachnoid layer of the spinal cord or the supporting glial (non-neuronal cells that provide support and nutrition) cells.
Diagnosis of Spinal Cord Tumor
The Diagnosis consists of an evaluation of the symptoms followed by a through neurological examination and then imaging by MRI/CT of the affected part based on clinical localization. However whole spine screening image has to be done if multiple lesions noted or skip lesions suspected.
Treatments in Spinal Cord Tumor
The Treatment of spinal cord tumors is far more effective when the tumor is diagnosed early. The treatment varies on the type of tumor, the location and the extent of involvement but most require surgical Excision. All spinal cord surgeries need to be done with intra operative spinal cord monitoring.
Spinal tumors that are not intramedullary can be removed completely with excellent recovery.
Intramedullary tumors may require radiation/chemotherapy after surgical excision depending on the grade of the tumor.
Getting treated early is the keyIntramedullary tumors may require radiation/chemotherapy after surgical excision depending on the grade of the tumor.
Early diagnosis and surgical intervention prevents irreversible spinal cord damage due to chronic pressure and hastens neurological recovery, minimizes physical disability. Newer techniques are in the offing including stereotactic radiations but these are still in its infancy.
Dr. Deshpande.V. Rajakumar, M.CH,
Consultant Neurosurgeon,
Wockhardt Hospitals,Bangalore
For Appointments and Consultations with our Brain and Spine Doctors ,please email
Introducing the Sunet Clinic at Bangalore: Outpatient Timings now extended to 8pm
Thursday, July 23, 2009
Most of us today avoid a visit to a doctor or a hospital specially if it interrupts with our working hours. We felt that there was a genuine need to adjust our timings so that we can accommodate our visitors who could not visit us due to their work timings
We have decided to extend our timings to introduce "Sunet Clinic" which will be open from 5pm-7pm. You can call 6636666 for appointments or email us at enquiries@wockhardthospitals.net
We have decided to extend our timings to introduce "Sunet Clinic" which will be open from 5pm-7pm. You can call 6636666 for appointments or email us at enquiries@wockhardthospitals.net
Minimally Invasive Surgical Treatement for Compression Fractures
Vertebroplasty is minimally-invasive, outpatient procedure used to treat the pain associated with vertebral compression fractures caused by osteoporosis and tumoral lesions
It is an image-guided, minimally invasive surgical also used for treatment for pathological spinal fractures which is successful at alleviating the pain caused by compression fracture. It is accomplished by injecting orthopaedic cement through a needle into the fracture vertebra.
Indications
In elderly patients with vertebral fracture, secondary to Senile Osteoporosis, of vertebra, Haemangiomas of spine.
Patient Evaluation
First, the patient is evaluated clinically and basic blood investigations are carried out.X-ray of spine, and if needed, of other parts too, are also taken.MRI is optional, in the presence of neurological deficits, suspected malignancy .Medical evaluation, for medical disease is performed.
Vertebroplasty Procedure
Done under general anesthesia in the operation theater. A hallow needle is passed percutaneously through pedicles into the body of vertebra, which is fractured under image guidance. It is followed by injection of dye,to confirm if the needle has reached a safe spot in the affected spine.An orthopedic cement paste is injected through needle into the body of vertebra, under image guidance. Once adequate cement is injected, needle is removed.
Total time: 30min
Advantages of Vertebroplasty
- This technique provides immediate strength to the porous bone, rapid relief from pain and reduces the likelihood of fractures again.
- Immediate pain relief.
- Early mobilisation, so early return to normality.
- No brace/no bed rest.
- Minimal invasive procedure.
Risks
A small amount of cement can leak out of the vertebral body.Other possible complications include: infection, bleeding, rarely neurological symptom is noticed
Limitations of Vertebroplasty
- Not used for Herniated disc or arthritic back pain.Not a prophylactic treatment to prevent fracture.
- Not for correction of spinal deformities.
- Not for medically unfit patient and in healed fractures.
Vertebroplasty has been carried out in several cases at Wockhardt Hospitals, where there has been great success, in the ease of the procedure and in the outcome.
For consultation with our Bone and Joint doctors,please email enquiries@wockhardthospitals.net
For consultation with our Bone and Joint doctors,please email enquiries@wockhardthospitals.net
Thinking of Getting a Knee Replacement: Take a walk in the sun
According to scientists in Australia, walking in the sunshine could be a great way to delay your knee replacement.The findings claim that Vitamin D deficient people loose cartilage faster than those who are not vitamin D deficient .Sunlight is one of the best sources of vitamin D but the researchers warn there in Australia there seems to be a national trend of people avoiding the sun.
Tasmania, half the population is vitamin D deficient, and even people living in brighter parts of Australia, such as Queensland, are at risk of developing osteoarthritis in their knees.The head of the Musculoskeletal Unit at the Menzies Research Institute in Hobart, Professor Graeme Jones, has discovered that vitamin D keeps knee cartilage healthy.
"In summer you need five minutes of unprotected sun on your arms and face. Winter at this time of year you need about an hour a day in the middle of the day,"
Cartilage has vitamin D receptors, and while there is not much knowledge on exactly onwhat this vitamin D does in cartilage, but the results suggest that vitamin D helps cartilage metabolism, so it suggests cartilage is under hormonal control.that patients with healthy vitamin D levels maintained their cartilage for longer than those with a deficiency.
Read the entire findings at here
Sunshine and exercise could just be a very cheap prevention to an expensive health problem.
Professor Jones says more than two million Australians have osteoarthritis and treating them costs $9 billion a year.
The men and women he has studied are aged between 50 and 80 years old.
Professor Jones says more than two million Australians have osteoarthritis and treating them costs $9 billion a year.
The men and women he has studied are aged between 50 and 80 years old.
Read the entire findings at here
Brain Tumor Removed through Nasal Cavity:Expanded Endoscopic Transnasal Surgery
Wednesday, July 22, 2009
In a unique path-breaking surgery the neurosurgery team at Wockhardt Hospitals, Bangalore, performed a pioneering technique by which a brain tumor was removed using a 4mm endoscope that was guided through the patient’s nasal cavity. The surgery which demands exceptional skill and specialized equipment, was conducted on a 40 year old woman who was diagnosed with a brain tumor measuring 2 cm.
Endoscopes have been previously used for brain surgeries related to cavities within the brain and to remove tumors from the pituitary gland through the nose. But this is the first reported case in the country where an endoscope was used to remove a brain tumor from the sellaturcia without an open surgery.
Minimally Invasive Ligament Construction in Children
Tuesday, July 21, 2009
Anterior Cruciate Ligament injuries are becoming increasingly common in the young active individual. MRI has also contributed significantly to the early diagnosis of these injuries. Treatment of ACL (Anterior Cruciate Ligament) injuries in the child and young adolescent remains controversial. This is especially so in the case of small children whose skeletons are yet to mature.Any treatment plan must consider an assessment of the patients’ physical maturity, level of functional instability and identification of associated injuries. While a trial of non operative treatment may still be upheld by some, most reports of non operative treatment have demonstrated poor results. The natural history of the ACL deficient knee is one of recurrent episodes of giving way with resultant multiple meniscal tears and early degenerative arthritis.
Arthroscopic Reconstruction Transphseal Hamstring Graft
Arthroscopic ACL reconstruction is an elegant solution to this problem.Physeal sparing techniques have yielded poor results and therefore transphyseal techniques is one of the best solution to the problem.
The Hamstring tendon graft using semi tendinosus and Gracilis tendons or quadruped semi tendinosis graft provides an exceptionally strong and reliable graft. It has the added benefit of being harvested through a small unobtrusive incision. There is no post operative morbidity (as with B.T.B. graft) and the tendons grow back in time.
A quadrupled hamsting tendon provides 250% strength of the normal A.C.L. The most contemporary concept of double bundle grafting can only be affected with Hamstring tendon grafting.
Graft selection is the corner stone upon which optimal intra-articular ACL reconstruction is built; however graft fixation is important to allow early aggressive rehabilitation post operatively. Excellent initial graft fixation strength is essential for good graft tunnel bonding and therefore contributes immensely to the final outcome of this surgery. The first weeks are especially critical.
At the WOCKHARDT KNEE CLINIC we have been using the BIOTRANSFIX system for Femoral tunnel fixation with Bio-interference screw for tibial fixation with excellent results in 77 patients so far. The procedure is especially safe for young children who have significant growth left.
Dr. Gautaum Kodikal, M.S.
Consultant Orthopedic Surgeon
Department of Bone & Joint Care
Wockhardt Hospitals, Bangalore
Dr. Gautaum Kodikal, M.S.
Consultant Orthopedic Surgeon
Department of Bone & Joint Care
Wockhardt Hospitals, Bangalore
Interventional Cardiologist at Bannerghata Road,Bangalore
Dr Subash Chandra
MRCP, FRCP
Consultant Cardiologist
Dr Chandra has over 27 years of experience in cardiology.He has worked at the The Royal Surrey County Hospital, Guildford, and at The General Infirmary, Leeds. He holds a degree in advanced fellowship in cardiology, he became an instructor in medicine and an attending physician (division of cardiology) at Cornell University Medical College and Hospital Cornell Medical Center, New York.
To view his detailed profile Click here
For scheduling an an consultation with Dr Subash Chandra click here
Dr. P. Ranganath Nayak
MD, DM
Consultant Cardiologist
To view his detailed profile Click here
For scheduling an an consultation with Dr Subash Chandra click here
Dr. P. Ranganath NayakMD, DM
Consultant Cardiologist
Dr Nayak is one of the most experienced cardiologists in this region with over 25 years of experience in the field of cardiology.His special interest areas include complex coronary interventions, like chronic total occlusions and primary angioplasties
Dr Nayak is trained in interventional cardiology from Epworth Hospital, Melbourne, Australia and University Hospital, Rouen, France.
To view Dr Nayak's detailed profile Click here
For scheduling an an consultation with Dr Ranganath Nayak,Click here
Dr Nayak is trained in interventional cardiology from Epworth Hospital, Melbourne, Australia and University Hospital, Rouen, France.
To view Dr Nayak's detailed profile Click here
For scheduling an an consultation with Dr Ranganath Nayak,Click here
3 Cm Incision to Correct Spinal Instabilty:Advanced Minimal Access Spinal Surgery
Sunday, July 19, 2009
Imagine a 3 centimeter incision to treat a case of severe spinal instabilty. !!
Wockhardt Hospitals Mulund, Mumbai, successfully performed the most advanced minimally invasive spine surgery called Transforaminal Lumbar interbody Fusion (TLIF) surgery to treat unstable spine.
Transforaminal Lumbar interbody Fusion (TLIF) is a very recent, most advanced and highly skilled form of spine surgery for fusion of two or more vertebrae of the lumbar (lower back) spine. The minimally invasive technique is best recommended for appropriately screened patients suffering from Degenerative spondylolisthesis, degenerative disc disease, lumbar canal stenosis, black disc, nerve compression with associated low back pain.
Until recently, all patients for fusion surgeries of the lumbar spine have had to undergo a strenuous surgical procedure known as Posterior Lumbar Interbody Fusion (PLIF) involving large midline incisions for cutting of muscles, ligaments and bone in the lower back. While PLIF surgeries are known to offer good results, the surgery involves large incisions that could cause damage to important muscles, intraoperative bleeding followed by prolonged bed rest. Additionally, there is increased chance of nerve injury due to handling of nerve tissues during surgery - all of which could lead to Failed Back Surgery Syndrome.
TLIF Surgeries have been Pioneered at Wockhardt Hospitals,Mulund according to Dr. Vikas Gupte, Consultant Spine Surgeon, Wockhardt Hospitals , “TLIF is far more beneficial than conventional PILF surgeries as it is a minimally invasive surgery done through a 3-cm incision. The surgery has hardly any bleeding and there is no need for blood transfusion. Further advantages include preserving the normal structures of the body. The patient can be mobilized faster and can stand and walk the day after the surgery.”
“Various factors are taken into consideration before recommending a TLIF, including the condition to be treated, age and health of the patient, lifestyle and anticipated level of activity following surgery,” explains Dr. Gupte. As such, patients suffering from Degenerative spondylolisthesis, Degenerated disc disease, Black disc, Foraminal /lateral stenosis, Spondylolysis - Instability, and Nerve compression with associated low back pain may be candidates for TLIF.
The patients was able to walk the very next day following the TLIF which is a three and-half-hour procedure. They were discharged around the fourth day after the surgery. However, physiotherapy and exercise was advised from Day 1. Their recovery was faster within three to four days as compared to two-three months following PILF surgery.
About Wockhardt Hospitals Spine Centre,Mulund,Mumbai
The Wockhardt Hospitals Spine Centre at Mulund provides advanced micro-surgical techniques to treat complex Spine disorders. This super specialty center is amongst the few in Asia equipped with most advanced Neuro-navigation and Endoscopic facilities to perform complex spine neurosurgeries. The centre has a vastly experienced team of Neuro-Spine surgeons and Neurologists, backed by the most comprehensive neuro-diagnostic and imaging facilities, positions the hospital among the best in the region.
For consultations and appointments with Spine Surgeon,Dr Vikas Gupte email us at enquiries@wockhardthospitals.net
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