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Spinal and spinal cord tumour surgery in Tijuana — Dr. Carlos A. Noreña Osterroth
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Spinal and spinal cord tumour surgery in Tijuana

Tumours of the vertebral body, the canal or the cord itself. The aim is to decompress the cord, stabilise the spine and obtain a diagnosis — in that order of urgency.

Where the tumour sits changes everything

In the spine, location rules. Extradural tumours — most often metastases from breast, lung, prostate or kidney — destroy the vertebral body and compress the cord from outside; there the priority is rapid decompression and stabilisation. Intradural extramedullary tumours, meningiomas and schwannomas, lie inside the dural sac but outside the cord, are usually benign and offer a good dissection plane.

Intramedullary tumours arise within the cord itself: ependymomas, astrocytomas, haemangioblastomas. These are the most delicate, operated under the microscope with neurophysiological monitoring, and in them the limit of resection is set by function, not by the image.

The warning that must not be missed

Back pain that wakes you at night, does not settle with rest, comes with weight loss or occurs in someone with a cancer history is not ordinary lumbago. If weakness in the legs, sensory change or loss of sphincter control appear as well, cord compression is an emergency measured in hours.

When metastatic compression is treated before the patient loses the ability to walk, many keep walking; once it is lost, regaining it is far less likely. That is why these cases are assessed the same day.

What the procedure involves

Whole-spine MRIAll three segments are studied: metastases are frequently multiple.
Cord decompressionAbsolute priority when there is progressive neurological deficit from compression.
Instrumented stabilisationScrews and rods when tumour has destroyed the vertebral body and left the spine unstable.
Intradural microsurgical resectionMeningiomas and schwannomas resected along a dissection plane, with monitoring.
Biopsy and oncology teamworkHistological type defines radiotherapy, systemic treatment and prognosis.

When it is indicated

  • Vertebral metastasis with cord compression
  • Intradural extramedullary meningioma or schwannoma
  • Intramedullary tumour with progressive deficit
  • Pathological vertebral fracture from tumour
  • Primary bone tumour of the spine
  • Refractory axial pain from a vertebral tumour

Techniques and resources

  • Operating microscope
  • Neurophysiological monitoring
  • Spinal instrumentation
  • Ultrasonic aspirator
  • Whole-spine MRI
  • Histopathology

Frequently asked questions about spinal tumour surgery

Yes, it warrants prompt assessment. In a patient with a cancer history, new or night-worsening back pain requires ruling out vertebral metastasis with MRI, particularly if there is weakness, tingling or difficulty passing urine.

It depends. Benign intradural tumours such as meningioma or schwannoma are usually resected completely with very good results. In metastatic disease the goal is typically to decompress, stabilise and preserve walking, while oncological treatment controls the disease.

The best predictor is the function you had before surgery. Those who arrive walking generally keep walking; those who have been unable to walk for days are less likely to regain it. That is why assessment should not be postponed.

Neurosurgical consultation

Bring your imaging and settle the question

One consultation with your MRI or CT in hand is worth more than ten internet searches. Book by phone or through the form and you will be told what is there, what it means and what your options are.

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