Spinal tumors — whether primary bone tumors, intradural tumors, or metastatic disease from cancers originating elsewhere in the body — can cause severe back pain, pathologic fractures, spinal instability, and neurological compromise. Surgical treatment aims to relieve pressure on the spinal cord and nerves, stabilize the spine, and when appropriate, resect the tumor to control local disease.
What Is Spinal Tumor?
Spinal tumors are broadly classified by their location and origin. Vertebral (extradural) tumors arise from or metastasize to the bone of the vertebra itself — the most common type in adults, frequently representing metastatic spread from breast, lung, prostate, renal, or thyroid cancer. Intradural tumors arise within the spinal canal, either outside the spinal cord (extramedullary — such as meningiomas and nerve sheath tumors) or within the cord itself (intramedullary). Each category has distinct surgical considerations and goals.
For metastatic vertebral disease, the surgical goals are decompression of the spinal cord and nerve roots (to relieve neurological compromise), stabilization of pathologically fractured or unstable vertebrae (to restore mechanical support and reduce pain), and local tumor control when resection is feasible. Modern techniques including separation surgery — which achieves circumferential decompression of the spinal cord to allow stereotactic radiosurgery to treat the residual tumor — have improved outcomes for carefully selected patients. Percutaneous cement augmentation (kyphoplasty/vertebroplasty) can stabilize painful vertebral metastases without open surgery in appropriate cases.
Primary spinal tumors — including osteoid osteoma, osteoblastoma, giant cell tumor, chordoma, and others — are less common and often require en bloc resection (removal of the tumor as a single intact specimen) to achieve the best oncological outcome. This is complex surgery requiring detailed pre-operative planning, multi-disciplinary input from oncology, and in some cases interventional radiology for tumor embolization. Dr. Chavarria works collaboratively with oncology and radiation oncology teams to develop individualized treatment plans for each patient.
Are You a Candidate?
- Patients with metastatic spinal disease causing neurological compromise from cord or nerve root compression
- Patients with pathologic vertebral fractures from tumor involvement causing instability and severe pain
- Patients with primary benign spinal tumors (osteoid osteoma, osteoblastoma, giant cell tumor) requiring surgical excision
- Patients with primary malignant spinal tumors (chordoma, chondrosarcoma) requiring en bloc resection
- Patients with intradural extramedullary tumors (meningioma, schwannoma, neurofibroma) causing pain, radiculopathy, or myelopathy
- Patients with favorable systemic disease status and adequate functional reserve to benefit from surgical intervention
What to Expect
Pre-operative evaluation: MRI with and without gadolinium defines tumor extent, cord compression, and relationship to vascular structures. CT defines bony destruction for surgical planning. Biopsy may be required before surgery if the diagnosis is uncertain — improper biopsy of a spinal tumor can compromise subsequent en bloc resection options, so biopsy planning is done carefully with oncology input.
Multi-disciplinary coordination: Spinal tumor cases are reviewed with medical oncology, radiation oncology, and when relevant, interventional radiology for pre-operative embolization of hypervascular tumors. The surgical plan is individualized based on tumor type, extent, patient functional status, and overall prognosis.
Day of surgery: Procedure complexity and duration vary widely — from a 1–2 hour posterior decompression and stabilization for metastatic disease to a multi-day staged resection for a primary tumor. Neuromonitoring is used throughout. Blood loss can be significant for vascular tumors; cell salvage and pre-operative embolization reduce transfusion requirements.
Post-operative: Inpatient stay ranges from 2–7 days. Adjuvant treatments — radiation, stereotactic radiosurgery (SRS), systemic therapy — are coordinated with the oncology team and typically begin 2–4 weeks after surgery once wound healing is confirmed. Surveillance imaging monitors local recurrence.
Why Choose Dr. Chavarria for Your Spinal Tumor in Reno?
- Surgical decompression can reverse or prevent progression of neurological deficit from cord compression
- Stabilization eliminates pathologic fracture pain and restores the ability to ambulate and perform daily activities
- Separation surgery enables stereotactic radiosurgery for durable local tumor control with lower radiation toxicity
- En bloc resection of primary tumors offers the best chance of oncological cure or long-term disease control
- Coordinated multi-disciplinary approach integrating surgery, radiation, and systemic oncology
- Minimally invasive techniques used when appropriate to minimize recovery time and allow timely adjuvant therapy