11.11.2015

Top neurologist salary

A spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and spinal column, in which cells grow and multiply uncontrollably, seemingly unchecked by the mechanisms that control normal cells. 1) Intradural-extramedullary: These tumors develop in the spinal cord's arachnoid membrane (meningiomas), in the nerve roots that extend out from the spinal cord (schwannomas and neurofibromas) or at the spinal cord base (filum terminale ependymomas).
2) Intramedullary: These tumors grow inside the spinal cord or individual nerves, most frequently occurring in the cervical (neck) region. 3) Extradural: These lesions are typically attributed to metastatic cancer or schwannomas derived from the cells covering the nerve roots. Prompt diagnosis and identification of the primary malignancy is crucial to overall treatment. Intracranial (brain) tumors account for 85 to 90 percent of all primary central nervous system (CNS) tumors. Metastatic spinal tumors are the most common type of malignant lesions of the spine, accounting for an estimated 70 percent of all spinal tumors. Neurofibromatosis 2: In this hereditary disorder, benign tumors may develop in the arachnoid layer of the spinal cord or in the supporting glial cells. Von Hippel-Lindau disease: This rare, multisystem disorder is associated with benign blood vessel tumors (hemangioblastomas) in the brain, retina and spinal cord and with other types of tumors in the kidneys or adrenal glands.
Non-mechanical back pain, especially in the middle or lower back, is the most frequent symptom of both benign and malignant spinal tumors. Depending on the location and type of tumor, other signs and symptoms can develop, especially as a malignant tumor grows and compresses on the spinal cord, the nerve roots, blood vessels or bones of the spine.
A thorough medical examination with emphasis on back pain and neurological deficits is the first step.
X-ray: Application of radiation to produce a film or picture of a part of the body can show the structure of the vertebrae and the outline of the joints.
After radiological confirmation of the tumor, the only way to determine whether the tumor is benign or malignant is to examine a small tissue sample (biopsy) under a microscope. Staging classifies neoplasms (abnormal tissue) according to the extent of the tumor, assessing bony, soft tissue, and spinal canal involvement. In cases in which surgical resection is possible, preoperative embolization may be used to enable an easier resection.
The posterior approach allows for the identification of the dura and exposure of the nerve roots. The typical hospital stay after surgery to remove a spinal tumor is about 5-10 days, depending on the patient’s case. Outcome depends greatly on whether the spinal tumor is benign or malignant, primary or metastatic, and on the age and overall health of the patient.


They typically derive from glial or ependymal cells that are found throughout the interstitium of the cord. Occasionally, an extradural tumor extends through the intervertebral foramina, lying partially within and partially outside of the spinal canal. Estimates indicate that at least 30 percent and as high as 70 percent of patients with cancer will experience spread of cancer to their spine. Primary tumors arising from the spinal cord, spinal nerve roots, and dura are rare compared to CNS tumors that arise in the brain. However, the more common tumors associated with this disorder affect the nerves related to hearing and can inevitably lead to loss of hearing in one or both ears. If the tumor is malignant, biopsy also helps determine the cancer's type, which provides information that helps determine treatment options. A whole body scan utilizing nuclear technology may be ordered, as well as a CT scan of the lungs and abdomen for staging purposes. Primary spinal tumors may be removed through complete en bloc resection for a possible cure.
This procedure involves the insertion of a catheter or tube, through an artery in the groin. Multiple levels can be decompressed epidurally, and a posterior multilevel segmental fixation can be performed. A period of physical rehabilitation is required post surgery, which may require a stay in a physical rehabilitation hospital for a period of time. In the case of primary tumors, the goal is to remove the tumor completely, leading optimally to potential cure of the malignancy. Primary tumors originate in the spine or spinal cord and metastatic or secondary tumors result from cancer spreading from another site to the spine.
Additionally, they are also classified by their location in the spine – anterior (front) and posterior (back). These include osteoid osteoma, osteoblastoma, osteochondroma, osteosarcoma, Ewing sarcoma, eosinophilic granuloma, aneurysmal bone cyst, chordoma, mesenchymal chondrosarcoma, giant cell tumor of bone, fibrous dysplasia, fibroma, angiosarcoma, and hemangioma. Spinal cord lymphomas, which are cancers that affect lymphocytes, a type of immune cell, are more common in people with compromised immune systems. The above findings and results from laboratory tests are compared to the patient's symptoms to confirm diagnosis. In patients with metastatic tumors, treatment is primarily palliative, with the goal of restoring or preserving neurological function, stabilizing the spine, and alleviating pain.
The catheter is guided up through the blood vessels to the site of the tumor, where it delivers a liquid embolic agent similar to glue, which blocks the vessels that feed the tumor.


The anterior approach is excellent for decompressing ventral tumors and effectively reconstructing the anterior column.
In other cases, physical therapy may take place at an outpatient facility or at the patient’s home. Clinically, they are divided according to location into three major groups: intradural-extramedullary, intramedullary, and extradural. Lung cancer is the most common cancer to metastasize to the bone in men, and breast cancer is the most common in women. Unlike adults, children have not achieved complete skeletal growth, which must be taken into account when considering treatment.
There appears to be a higher incidence of spinal tumors in particular families, so there is most likely a genetic component.
Pain may spread beyond the back to the hips, legs, feet or arms and may worsen over time, even when treated by conservative, nonsurgical methods that can often help alleviate back pain attributed to mechanical causes. Generally, surgery is only considered as an option for patients with metastases when they are expected to live 12 weeks or longer and the tumor is resistant to radiation or chemotherapy. The total recovery time after surgery may be as short as three months or as long as one year, depending on the complexity of the surgery and the patient’s overall health.
At best, treatment may provide the patient with an improved quality of life and prolonged life expectancy. Intramedullary lipomas are rare congenital tumors most commonly located in the thoracic spinal cord. Other cancers that spread to the spine include gastrointestinal tract, lymphoma, melanoma, kidney, sarcoma, and thyroid. Other things to consider are spinal stability, surgical versus nonsurgical interventions, and preservation of neurological function.
Indications for surgery include intractable pain, spinal cord compression, and the need for stabilization of impending pathological fractures. Thoracic and lumbar spinal tumors that affect both the anterior and posterior vertebral columns are a challenge to resect completely.




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