He will also perform
surgery in order to stabilize the spine if it becomes unstable due
to the tumor. A few tumors are insensitive to radiation or
chemotherapy, so surgery may be the only option.
The following are types of spinal tumors Dr. Berti treats:
Meningioma: A meningioma is a type of tumor that develops from the
meninges, the membrane that envelops the brain and spinal cord.
Spinal meningiomas account for less than 10% of meningiomas, and are
more common in women than in men in later years. Meningiomas are
intradural-extramedullary tumors which occur in the thoracic spine.
Most meningiomas are considered benign, but that can be misleading,
as the growing tumor may compress the nerves and cause pain or nerve
damage when they run into the spinal cord. They can also recur and
become cancerous.
Treatment: Resection and radiotherapy (such as CyberKnife) are the
recommended treatments.
Schwannoma:
A Schwannoma, also known as neurinoma or neurilemmoma, is typically
a benign tumor which arises from the cells that form the myelin
sheath around peripheral nerve fibers (the nerves outside the brain
and spinal chord). Schwann cells are cells that cover the nerve
fibers involved in conducting nervous impulses in the body. A
Schwannoma tumor grows on a nerve, displacing it to the side. It is
the most common intradural extramedullary lesion, accounting for 30%
of all primary spine neoplasms.
Treatment:
Total microsurgical resection or laminectomy is recommended. (link
to appropriate procedures page)
Neurofibroma:
A neurofibroma is typically a benign tumor of the cells that support
peripheral nerves, or the nerves outside the brain and spinal cord.
The cause is unkown. Some symptoms include painless, slow growing
mass, electric like shock when affected area is felt (known as "Tinel
sign"), usually no neurological problems or loss unless the tumor
involves a major motor or sensory nerve or is compressed between the
tumor and a rigid structure.
Treatment:
If the neurofibroma is not involved with a major nerve, an operation
to remove the nerve containing the tumor is usually the treatment of
choice. If a major nerve is involved, doctors may choose to excise
the tumor from the nerve, leaving the nerve itself intact, or leave
the tumor alone, if it isn't causing any symptoms. Surgery,
radiation, and/or chemotherapy may also be used to control or reduce
the size of optic nerve gliomas when vision is threatened. Some bone
malformations, such as scoliosis, can be corrected surgically.
Ependymomas:
One of the most common types of spinal tumors, ependymomas arise
from the cells lining the canal in the center of the spinal cord.
They are typically non-cancerous, and slow growing. They are found
mostly in adults. They can be intradural/extramedullary or
intramedullary.
Treatment: An ependymoma is usually removed with surgery, radiation
therapy, or a combination of both. (link to appropriate procedures
page)
Astrocytomas:
Astrocytes are star-shaped glial cells that form part of the
supportive tissue for the brain. One of the most common gliomas, the
astrocytoma develops on spinal cells called astrocytes and accounts
for half of all primary brain and spinal cord tumors. They are more
prevalent in adults.
Symptoms vary depending on the location of the tumor, but may
include persistent headaches, double or blurred vision, loss of
appetite, changes in mood and personality, vomiting, and changes in
ability to think and learn, among others.
Treatment:
The main goal of treatment is to remove as much of the tumor as
possible without injuring brain tissue vital to a patient's normal
function. Even if the tumor is cannot be completely removed, Dr.
Berti will perform any of a number of treatments to reduce tumor
size; for example, he may opt to surgically resect the tumor via
craniotomy to reduce the tumor size. Other treatment options include
radiation therapy and chemotherapy.
Because high grade glial tumors have a high incidence of recurrence,
Dr. Berti might also use radiosurgical techniques like CyberKnife to
complete the removal. He may also opt to use radiosurgery in cases
where the tumor is close to critical portions of the brain, for
patients who can't tolerate daily radiation doses, or for people who
are otherwise not candidates for surgery. Rest assured, Dr. Berti
will create the appropriate treatment plan for his patients based on
a variety of factors.
Intramedullary lipomas:
Intrtamedullary lipomas of the spinal cord are extremely rare. They
are typically associated with spinal dysraphism, or the defective
closure of the neural tube. They present in the first two to three
decades of the patient's life and affect both sexes equally.
Symptoms include ataxia (lack of coordination while performing
movements), pain, lower extremity weakness, and sensory disturbances
(injured sensory pathways in the spinal cord).
Treatment includes resection and decompression, with an emphasis on
decompression, as intramedullary (and extramedullary) lipomas are
typically involved with the surrounding nerves. Studies have shown
that subtotal removal carries no higher risk of recurrence than
total removal.
Metastatic cancer:
Spinal metastases can occur when tumor cells travel from the
primary, or original, site of a tumor to another place in the body.
Spinal metastases most commonly migrate to the spine. Metastatic
spinal tumors are usually extra-dural, growing outside the dura
mater in the bones of the spine. Those tumors affect the spinal cord
and spinal nerves by causing pressure.
Treatment depends on a variety of factors in the case of metastatic
cancer; for example, the number of tumors and the location of the
tumors, whether the primary tumor has been cared for, as well as age
and general health. Doctors use resection, radiation therapy, and
chemotherapy to treat these tumors. Newer types of therapy include
stereotactic radiosurgery such as CyberKnife or XRT, depending on
the size of the tumor.
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