New Technique for Spinal Surgery

A novel technique allows surgeons to remove tumors from the cervical region of the spine that were previously considered inoperable.

Called a lateral paramedian transpedicular approach, the surgery uses standard and innovative devices to first remove and then reconstruct portions of the cervical spine in order to access tumors. After the bone is removed, surgeons have a direct line of sight to the tumor and are able to remove it without moving or manipulating the spinal cord.

After removing the tumor, surgeons rebuild the spine with artificial pedicle screws. This technique is especially useful in cases where the tumor is located in the middle of the spinal canal and attached to the lining of the spine. Tumors such as meningiomas, neurofibromas, and exophytic astryocytomas are examples of tumors for which the technique is useful. To date, most of the surgeries performed have been done on patients with neurofibromas, which often sit just below the brain stem and press against the spinal cord as they grow.

Because of the proximity to sensitive anatomy, such as the spinal cord, pharynx, nerves, and major blood vessels, many surgeons refuse to operate for fear of causing irreversible damage, paralysis, or death. As a result, many patients with extensive intradural tumors are not treated.

The new technique was developed by Christopher Ames, M.D., director of the spinal biomechanics and spinal neuronavigation laboratory at the University of California, San Francisco (CA, USA). A report on the new technique appeared in the November 2005 issue of Operative Neurosurgery.

"We are treating patients with this technique who were told by physicians that nothing more could be done,” said Dr. Ames. "The next step is to train other surgeons in the technique so it is accessible to patients throughout the country.”




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University of California, San Francisco