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“ SPINE TUMOURS CAN PRESENT
WITH BACK PAIN, NECK PAIN
MIDDLE BACK PAIN AND LOSS OF
STRENGTH OR FEELING IN THE
ARMS OR LEGS OR SOMETIMES
BOTH. ”
Guidance linked to MRI and CT scans, and finer tools for tumour
removal. New generation laser systems and even superior to
laser technology is now available for spine tumour treatment
and removal. Reconstrution of the spine with modern materials
such as titanium, ceramamics/PEEK to replace the vertebrae and
maintain the spine canal and nerve openings can be done. Parts
of the tumour that are difficult or risky to remove can be treated
later by other modalities such as Radiosugery. According to Dr
Prem Pillay, radiosurgery has become a major and useful tool in
the treatment of spine tumours. Radiosurgery uses precision and
guided energy beams that penetrate painlessly and invisibly to
the tumour site without needing an open operation. There are a
wide range of radiosugery platforms including Tomotherapy, LINAC
(linear accelerator) systems with micro-multileaf collimators for high
precision and the ability to treat the spine. There are tumors that can
be treated with radiosurgery alone without open surgery as the first
step. Malignant tumours may need several modalities of treatment
including surgery, radiation and chemotherapy. There are also a new
generation of anti-tumour biologics which have less side effects
than conventional chemotherapy and can be used for malignant
tumours including malignant astrocytomas and gliomas.
Spine Tumours
WHAT IS IT AND HOW CAN YOU GET IT CURED
: A REASON FOR BACK PAIN, NUMBNESS AND
WEAKNESS
Although spine tumours can be dangerous and devastating in
adults and children ,Dr Prem Pillay believes that earlier diagnosis
and the use of technologically advanced tools and furthur research
including microsurgery, robotics and radiosurgery is playing a role
in saving many people from pain and disability throughout the
world including Singapore.
Spine Tumours refers to tumors that grow in or around the spinal
cord and nerves and can cause severe disability and even paralysis
if undetected and untreated by damaging the spinal nervous
system. According to Dr Prem Pillay, a Senior Neurosurgeon and
Spine Specialist based in Singapore, the number of people affected
by these tumors is increasing because of better detection and also
our aging population. These tumours can also affect children. There
are two categories of spine tumors. There are those that are benign
and often slow growing such as Meningiomas, Neurofibromas/
Schwannomas, and hemangiomas/cavernomas and AVMs. These
can sometimes reach a large size by the time symptoms appear so
Dr Prem Pillay advocates early detection in order to increase the
chance of a smaller tumor size at diagnosis. The second category
of tumors are those that are more malignant. They start either in
the spinal cord or elsewhere, for example someone who already has
breast or lung cancer. This may cause the spinal vertebrae to weaken
and be associated with painful fractures (Pathological fractures).
Tumours that start in the spinal cord are often Gliomas including
astrocytomas. They can be low grade meaning slow growing but
there are also malignant versions the most serious of which is called
Glioblastoma.
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Spine tumours can present with back pain, neck pain middle back
pain and loss of strength or feeling in the arms or legs or sometimes
both. Other symptoms include numbness/tingling in the body or
limb, loss of coordination of movements, and much more. However,
again Dr Pillay observes that neck and back pain is often from
slipped discs or spine degeneration rather than a spine tumour.
Evaluation of the problem by a qualified medical specialist can
help in arriving at a diagnosis. He has observed that many patients
resort to traditional treatments and massages but he suggests that
if these therapies do not help within three sessions, you should
seek advice from a real Spine Specialist. Medical specialists use MRIs
and other tests to confirm the diagnosis. The MRI clearly shows the
nervous system of the spine, as well as the size and location of any
tumours. Advanced tests such as a PET scan may be done if cancer
is suspected that may have spread to the spine. A Biopsy may be
needed to know the tumour type particularly if cancer is suspected
and involves the spinal bones.
Dr Prem Pillay is the Medical
Director of a multidisciplinary spine
and pain center in Singapore, which
offers the full range of services
including: Back Pain and Neck
Pain Solutions, Minimally Invasive
Spine Microsurgery, Spine and Pain
Injections (Day Treatments) and
Spine Tumor Ma nagement.
In the past the treatment modalities for spinal tumours in adults
and children was often limited to the use of surgery alone. Modern
surgery includes the use of high end neuro microscopes, Computer
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