Rarely, tumors can form within nerves or the thecal sac of the spine.
The spine is a bony structure that protects the nerves, which are housed in a sac we call the thecal sac.
Neuromas, schwannomas, meningiomas, epeyndymomas, and gliomas are all examples of tumors that can grow within this sac.
As they grow, they place pressure on the nerves, and can cause weakness, numbness, tingling, or pain.
Surgery is meticulous for such cases, and often require specialized OR’s, high magnification microscopes, and very fine micro-instruments to carefully dissect the tumor while preserving your nerves.
EvergreenHealth is proud to have surgeons and the necessary equipment to take care of these rare cases.
Depending on the site of the tumor, you will most likely be placed face-down on a specialized operating room table.
The surgeon then uses fluoroscopy to localize the exact location of the tumor, and makes an incision directly over it.
Soft tissue and muscles are carefully retracted away from the spine.
The surgeon then uses drills and instruments to remove the bone necessary to access the thecal sac.
Once exposed, a specialized microscope is brought into the field.
Under high magnification, the surgeons then open the thecal sac, and use micro-instruments to carefully navigate and separate the nerves from the tumor.
Once the tumor is isolated and all the nerves are protected, the tumor is resected.
Nerve stimulators are used throughout the surgery to stimulate each individual nerve to ensure their function.
Once the tumor is removed and sent off to pathology, the thecal sac is closed with very small stitches under the microscope.
Dural grafts and a specially-formulated glue is placed over the stitches to bolster the closure.
The muscles, fascia, and skin are closed next.
Oftentimes, tumors within the thecal sac are benign, but because of their growth and location, they can place pressure on the nerves and spinal cord, causing significant problems.
By removing the tumor, we can prevent further growth and pressure on the nerves, thereby preventing further deterioration down the road.
In some patients with weakness, improvement can occur with aggressive physical therapy and rehabilitation.
Sometimes, these tumors may be cancerous, or malignant, and resection or biopsy of the tumor is needed for pathological diagnosis to help direct chemotherapy and radiation plans.
After the operation, patients are instructed to lie flat in bed for 1-2 days.
Gradually, the team will start getting you up, and begin walking.
Sometimes, an MRI will be done afterwards as well.
When you go home, we encourage ample walking, stairs, and activities of daily living.
We do not recommend vigorous exercise, sports, lifting more than 10lbs, or any strenuous activities.
After 4 weeks of healing, you will begin physical therapy, and begin increasing your activity level, with the goal of getting back to normal by 3-4 months.
Let us connect you with a physician who can help you get back to living with less pain.