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Spinal tumors are quite rare but very difficult to diagnose and manage. They can be divided into primary tumors, which originate in the spine, and secondary tumors, which are metastases that spread from other parts of the body. It is important to note that secondary spinal tumors occur in over 90% of cases, whereas primary spinal tumors occur in less than 10% of cases.
Timely diagnosis and correct identification are vital for other management options and a better outcome for patients.
Clinical Presentation of Spinal Tumor:
Patients with tumors of the spine can have a variety of presenting symptoms, including:
Regular Spine and Neck Pain:
- Patients with spinal tumors commonly complain of unrelenting neck or back pain that is progressive, non-exertional, and worse at night.
- In rare situations, a patient with a past history of malignancy may report new-onset or worsening spinal pain, arousing suspicion for metastatic disease.
Neurological Deficits:
- Depending on the tumors of the spine, radiculopathy or myelopathy, the patient may have neurological issues.
- Some lesions, especially benign tumors such as hemangiomas or fibrous dysplasias, can remain asymptomatic and are discovered incidentally in imaging studies.
Diagnostic Methods of Spinal Tumor
There are different ways to detect a spinal tumor depending on the situation this would usually involve advanced imaging techniques:
- Magnetic Resonance Imaging (MRI): Shows in detail soft tissues, cord involvement, and tumor spread.
- Computed Tomography (CT): Gives accurate data on bony details and is useful in measuring cortical involvement.
- Technetium Isotope Bone Scan: Identifies lesions for localization and determination of multiple site involvement.
- Positron Emission Tomography (PET): Differentiates neoplastic disease from infectious illness.
Principle of Biopsy Techniques:
Biopsy is a critical procedure in the diagnosis of spinal tumors, which directs treatment. The major principles are:
Careful Planning: The tract of the biopsy must be planned carefully so that uninvolved tissues are not contaminated. All tissues exposed to the biopsy are contaminated with tumor cells, therefore, careful hemostasis is essential. Hematomas that occur post-operatively are also contaminated and must be treated accordingly.
Technique Choice: Choices are fine needle aspiration (FNA), core needle biopsy, incisional biopsy, and excisional biopsy. The selection is based on tumor size, location, and hypothesized pathology.
Expertise and Coordination: The procedure should be done by or in collaboration with an orthopedic oncologist to ensure correct technique and avoid jeopardizing future treatment possibilities.
Spinal tumor treatment is multidisciplinary and includes orthopedic surgeons, oncologists, radiologists, and pathologists
Conclusion:
Spinal Tumor is rare but complex, it needs proper planning to operate it.To know more about the spinal tumors and biopsy fundamentals, subscribe to Conceptual Orthopedics, Unlock access to extensive resources, expert presentations, and case discussion that will transform your clinical practice. Connect with a network dedicated to the pursuit of orthopedic excellence.
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