Rare surgery makes fixing spinal problems easy

Courtney Rogers is like any 16-year-old.

She's learning to drive and looking forward to prom.

A recent health scare made Courtney wonder if she'd be able to enjoy the rest of her teen years.

Doctors found a tumor on her spine.   It wasn't cancerous, but still posed dangers.

The tumor sat on the surface of Courtney's spine, a tricky area to reach.

The standard way to remove it is through a very large incision in the chest cavity.

One that's about 18 inches long, a rib is removed, and the chest cavity is spread widely apart.

Instead, Neurosurgeon Curtis Dickman used a breakthrough endoscopic technique on Courtney that only a few doctors in the world perform.

He made three small incisions in the spaces between her ribs.   Special tools were placed through the holes.

He clipped the vessels that supplied blood to the tumor and removed the tumor through the chest cavity.

The pain is much, much less and patients get out of the hospital much faster.

In fact,  with standard surgery, it's one to two weeks in the hospital.

With the new technique? One to two days.

Courtney's tumor is completely gone, allowing this teen to enjoy all the sweet things in life.

More information on next page.

BACKGROUND: According to the Mayo Clinic, a spinal tumor is a cancerous or noncancerous growth that develops within or near the spinal cord or within the bones of the spine. Back pain is the most common symptom of a spinal tumor. A spinal tumor or a growth can impinge on nerves, leading to pain, neurological problems and sometimes paralysis. A spinal tumor, whether it is cancerous or noncancerous, can be life-threatening and can cause permanent disability.

TREATMENT: Doctors ideally have a goal of completely eliminating the spinal tumor, but this is often complicated by the risk of permanent damage to surrounding nerves. Treatment options may include:
• Monitoring: When spinal tumors are noncancerous and are not growing or pressing on surrounding tissues, doctors may be able to watch them carefully without any other treatment.
• Surgery: This is often the first step for treating tumors that can be removed without risking too much nerve damage. Newer techniques and instruments are allowing neurosurgeons to reach tumors that were once inaccessible. However, not all tumors can be completely removed with surgery.
• Radiation: When a tumor is inoperable or cannot be completely removed, radiation is typically a treatment of choice. It's also a first line treatment for tumors that have spread from other parts of the body.
• Stereotactic radiosurgery: This is a new method that is capable of delivering a high dose of precisely targeted radiation. It is now being studied for the treatment of spinal tumors.

AN EASIER SURGERY: 16-year-old Courtney Rogers had a ganglioblastoma paraspinal tumor. Although this type of tumor is benign, if it's not treated, it could grow and eventually impair movement and the lungs. The tumor was sitting on the surface of Courtney's thoracic spine, within the chest cavity. To remove tumors like this, doctors typically use an open surgery that requires making a 12-18 inch incision into the chest wall, removing a rib, and spreading/fracturing the ribs in order to reach the tumor. This surgery can be disfiguring and painful. It also requires a long recovery. Now, a few doctors around the world, including one at Barrow Neurologic Institute, are using an endoscopic type of neurosurgery where three or four incisions are made in the chest wall to remove the tumor. The hospital stay is usually one to two days, and the recovery is about two weeks. This is a vast improvement over the more traditional surgery.

Carmelle Malkovich
Public Relations
St. Joseph's Hospital and Medical Center
Phoenix, AZ
(602) 406-3319


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