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New Techniques Ease Spine Surgery

Improvements help alleviate pain for cancer patients

July 23, 2010 | LESLIE HILL

For cancer patients, quality of life is as important a consideration as quantity of life.

Now, for patients whose cancers have spread (metastasized) to the spine, a new “minimally invasive” approach to surgery can make it a more reasonable option than the previously required invasive procedure to ease sometimes excruciating and debilitating back pain.

“For the most part, surgical treatments of these spinal metastases is palliative,” said Matthew McGirt, M.D., assistant professor of Neurological Surgery. “Surgery is not meant to cure the cancer. It’s for improving the quality of life, pain control and function to a point they can live with for their remaining years.”

McGirt has just completed a fellowship in Spinal Oncology at The Johns Hopkins Hospital and is now practicing at the Vanderbilt Comprehensive Spine Center.

While surgery to rebuild the damaged spine is typically invasive with a large incision, significant tissue retraction and long recovery times, McGirt is bringing new, minimally invasive techniques.

“Typically, to access the front of the spine where most tumors spread, you have to open the body widely and often remove ribs and sacrifice normal vessels,” he said. “What I’m using are tubes to get to the front of the spine with small incisions and minimal collateral tissue damage. We can achieve spine stabilization and provide dramatic pain relief with much less of a recovery time.”

A minimally invasive approach also allows more patients, like those who have high bleeding levels or those who may not heal from a big incision, to consider the surgery.

“This opens it up to a new group of patients who may need the procedure just as much but who may not be able to tolerate the traditional approach,” McGirt said.

McGirt is also director of Clinical Spine Research and has set up a real-time monitoring system at the Comprehensive Spine Center to track outcomes with the minimally invasive approach compared to the traditional open surgery.

“We track patient-reported, not physician-reported, outcome measures from questionnaires patients fill out on how their pain, disability and quality of life are. Then we can critically evaluate how we’re doing,” McGirt said.

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