When cancer spreads from its primary location to other parts of the body it is referred to as metastatic cancer. Cancer can spread or metastasize to virtually any location in the body. When cancer spreads to the spine, it is referred to as spinal metastases. Spinal metastases occur in approximately 10% of all cancer patients. Common primary cancer sites that spread to the spine include lung cancer, breast cancer, colon cancer, melanoma and lymphoma. The main concern for spinal metastases involves its potential to compromise the structural integrity of the spinal column or to cause irreversible damage to the spinal cord and/or nerve roots. Structural integrity of the spinal column is compromised when metastatic tumors invade the spine and cause vertebral body collapse. Once the spinal column fractures, compression and destruction of the neural elements can occur. Likewise, spinal cord compression can also occur by the direct impact of tumor growth.
Symptoms of Spinal Metastases
Pain is usually the first symptom in patients with spinal metastases. The pain may cause focal back pain or may be radicular in nature when tumors affect a spinal nerve root. Alternatively, the patient may experience referred pain as a result of spinal metastases. Pain may be exacerbated by movement, recumbency, neck flexion or extension, coughing, sneezing, or straining. When tumors affect the spinal cord patients may experience leg stiffness, weakness, numbness, autonomic disturbances (urinary urgency or hesitancy, constipation, impotence).
Diagnosis of Spinal Metastases
Diagnosis of spinal metastases is made most definitively by needle biopsy. However, MRI may also be used when the diagnosis is already known. PET CT and bone scan may be used to survey the skeletal system for early detection of spine metastases and to assess the extent of the disease. CT scan is often used to evaluate the bony elements of the spinal column such as the vertebrae. CT scan will help physicians assess the structural integrity of the spinal column.
Treatment for Spinal Metastases
WARNING: If patients or healthcare providers suspect spinal metastases, neurosurgical evaluation is highly recommended!
Treatment for spinal metastases may be initiated by the administration of steroids. Steroids reduce inflammation and consequently relieve some of the pressure and irritation caused by the spinal tumor on the spinal cord or within the spinal column. Patients may experience transient neurologic improvement with the administration of steroids. Other treatment strategies include chemotherapy, radiation therapy, radiosurgery and surgery. It is imperative to identify situations in which spinal tumors do not respond to current treatment and when there are worsening symptoms. Unchecked progression of spinal metastases will almost always lead to significant spinal column instability, neurologic dysfunction and paralysis. Therefore physicians must be extremely vigilant when spinal metastases are detected in patients with metastatic cancer.
At Princeton Neurological Surgery, Dr. Lipani is a board-certified, fellowship trained specialist in spinal metastases. Dr. Lipani offers noninvasive radiosurgery for spinal metastases that do not respond to chemotherapy. In many cases, complex open surgical procedures can be avoided. In other more advanced cases, Dr. Lipani performs complex spinal surgery to treat spinal metastases and to restore the stability of the spinal column.
WARNING: Patients with spinal metastasis should be evaluated by a neurosurgeon with training in radiosurgery BEFORE the patient requires open surgery.
Dr. Lipani is a specialist in the treatment for spinal metastases and urges patients to consult with him at the time the spinal metastases are discovered. This way, Dr. Lipani can monitor the effects of current treatment and use radiosurgery to definitively treat the spinal metastasis and prevent continued growth. This will not only treat the patient’s symptoms but prevent further bony destruction of the vertebrae, avoid open surgery, prevent neurologic dysfunction and preserve quality of life. Furthermore, radiosurgery is more powerful than radiation therapy and is better able to protect healthy tissue. Please visit the JD Lipani Radiosurgery Institute, for non-invasive neurosurgery, to learn more about radiosurgery. To view case examples of what Dr. Lipani can do using radiosurgery, Click Here.
Dr. Lipani treats many other spinal conditions such as spinal stenosis, herniated discs, degenerative disc disease, low back pain, neck pain, spinal tumors, spinal cancer and more. Dr. Lipani treats patients from around the world, New York, Pennsylvania, and New Jersey including locally from Princeton, New Brunswick, Hopewell, Pennington and communities throughout Somerset, Middlesex, Ocean, Burlington, Monmouth and Mercer Counties for spinal metastases. Dr. Lipani offers image guided spine surgery approaches and the latest in noninvasive radiosurgery procedures for spinal metastases treatment, tailored to the needs of each patient. For state-of-the-art spinal metastases treatment, or to learn about CyberKnife radiosurgery, call or email us to schedule a consultation at our offices in Hamilton or Bridgewater, New Jersey!