Thoracic Tumor Surgery (Intradural and Extradural)

The spinal cord is made up of a bundle of nerves that carry motor and sensory impulses from the brain to the body and back. Tumors in the spinal cord are rare but when present they compress the spinal cord as they grow larger, causing loss of motor and sensory signals, limb dysfunction, and sometimes even death. The spinal cord is covered by three protective layers – the pia, arachnoid, and dura. The tumors are usually classified in relation to the outermost dura layer as intradural-extramedullary, intramedullary, and extradural and according to their position along the spine (cervical, thoracic, lumbar or sacrum). Thoracic tumor surgery is the surgical removal of spinal tumors present in the thoracic region (chest), in the space within (intradural) and outside (extradural) the dura mater.

Before surgery, a catheter (long narrow tube) may be inserted through an artery in the groin region and threaded to the tumor where a glue-like substance is instilled to block the blood supply that feeds cancer or inject the medication that will help shrink the tumor to a size that is easily resected through surgery. Thoracic tumor surgery is performed under general anesthesia with the patient lying in a prone position. An incision is made over the diseased region and the lamina (arched region of the vertebra protecting the spine from the back) is resected through a process called a laminectomy. This provides a clear view of the tumor, and regions of the healthy spinal cord above and below it.

In cases of an extradural tumor, the tumor is removed completely and the spine is stabilized through vertebral fusion, using a bone graft, pins or cages, to reduce the deformity that is left after tumor excision. To remove an intradural tumor, the dura matter is cut, opened out, and secured to the sides to expose the tumor. The tumor is then removed completely, making sure that the underlying spinal cord is not damaged. The incisions are then closed.

Following thoracic tumor surgery, you will stay in the hospital for 2 to 14 days, depending on the procedure. You will require physical rehabilitation. It may take you three months to one year for complete recovery from the surgery.