Professor MD Thomas Gösling
Benign tumors in spine have primary origin. According to the Enneking classification benign tumors can be divided to three classes depending on stage of development:
Even benign back tumor can cause unpleasant symptoms as pain and neurological disorders so it is worth to know the signs of spine tumor:
As above symptoms may be related to other diseases, it is important to have system examination to determine the cause of symptoms.
X-Rays is traditional mean of diagnosis that allows seeing related problems in bones but it s not very reliable for tumors.
CT scan is computer imaging system based on X-Rays imaging. It helps to create more clear picture of spinal canal and related bony structure but also not very good for soft tissues.
MRI is the most reliable method to diagnose tumor in spine. The technique is based on creating of magnetic images of the body that can be viewed on computer monitor. MRI shows the spinal cord together with nerves and their root, related tissues and tumors.
Biopsy is performed to determine whether the tumor is benign or malignant biopsy. During the procedure a small piece of tumor tissue is taken for histological test.
Enostosis, or Bone Island. It is latent lesion that is most often found accidentally during radiology. Normally, it does not need treatment.
Osteoid osteoma. It is active benign tumor of active type which occurs in children and adolescent, mostly in male. When present in spine it is prevalent in lumbar region or, next, in cervical region. It can produce scoliosis, radicular pain and gait disturbances and should be treated to avoid further complications. The common treatment is surgery.
Osteoblastoma. This spine tumor has similar nature to the previous one but manifests itself in another way. It is typically developed in young adult 20-30 years old more often in male than in female (3:2). Osteoblastoma can be found in cervical region, alike thoracic or lumbar and can extend to vertebral body. The symptoms are dull pain of localized character, paresthesias and even paralysis when the tumor is large enough. In aggressive stage, osteoblastoma may result in calcifications and sclerotic rims and, in severe stage, may expand to the bone and cause destruction, tissues infiltration and significant calcification. Osteoblastoma is treated by surgery but sometimes there is a risk of damage of vital vessels and nerves, so surgery should be carried out with high accuracy.
Aneurysmal bone cysts. Those benign cysts are multiloculated blood-filled inclusions in the bones. When spine is involved thoracic region is mostly affected, followed with cervical and lumbar spine. The probability of extension to the vertebral body is about 75%. The lesions can also penetrate adjacent tissues, vertebra, and disks. The methods to find liquid inclusion are CT scan or MRI. The treatment is normally surgical removal but a risk if recurrence is rather high.
Surgical treatment is a main procedure for localized spine tumors. Benign tumor are normally slowly grown and well shaped that means they are easy to be separated from surrounding tissues. In most cases, benign spine tumors do not spread metastases. Though it can grow for a long time asymptomatically, once discovered it is being removed. Completely removed tumor does not tend to recur. Depending of complexity and spine area the different surgical techniques may be applied.
Experience of the specialists of Spine Center in Clinic of Braunschweig allows performing the tumors surgery of any complexity. As a rule, Intradural-Extramedullary and Intramedullary Tumors is the subject for complete removal. Operation often includes the procedures to preserve and stabilize the spinal cord.
Surgeons get to the operation site via one of the following accesses:
The type of approach is always chosen based on individual situation and tumor location. In complex operation involving removal of vertebral body special devices are used to stabilize the spine during surgery as screws and cages. The direct operation on the spinal cord requires high skill of surgeon as it is easy to damage it that can lead to serious complications including paralyses. In Spine Center of Clinic of Braunschweig usually specialists of different fields are involved. Thus, the accident surgeon Dr. Ernst Rzesacz and neurosurgeon Dr. Martin Willmann perform complex operation together to provide accurate dissection of benign tumors and following preserving of the all nerve routes.
If you need professional advice of the surgeon on benign tumor removal please apply for consultation. Our Spine Center assures you in highest level of treatment with the best surgeons in Germany.