Surgery for Spinal Tumours

Abstract

This chapter considers surgical management of spinal tumours. Surgical considerations for spinal tumours relate to various clinical aspects: the nature of the patient’s symptoms and the prospect of surgery improving them or at least preventing decline, either due to continued growth of the tumour or bony destruction and instability. There is in addition the prospect of surgery being curative for benign tumours or rarely for isolated malignant tumours. Surgical considerations include the presence of disease elsewhere, the ease of complete or substantial resection of a tumour, or more simple surgery to relieve mass effect on neural structures. Spinal tumour surgery is complicated by the issue of stability and the need to stabilize the diseased spine in the presence of overt or impending mechanical failure causing neurological compression or intolerable pain. This is facilitated by many modern medical devices. Tumours of the spine are categorized according to their anatomical relations to the dura and the structures they arise from. Careful preoperative assessment, judicious use of modern equipment and techniques and good working relations with colleagues in other specialties will continue to underpin best management.