Stereotactic radiosurgery for spinal tumor

Stereotactic radiosurgery involves the use of precise targeting and multiple beams of high dose radiation to remove or destroy tumors and other defined lesions in a nonsurgical manner. Through the use of image-guidance and robotics, technology such as the Accuray Cyberknife ® is used in place of, or in conjunction with, conventional surgery.

Stereotactic Radiosurgery for Benign Tumors

Meningioma and nerve sheath tumors, such as neurofibroma and schwannoma, are relatively resistant to conventional radiation treatment because the dosage tolerated by the spine and adjacent normal tissues is limited.

Unlike metastatic tumors that primarily affect the bones of the spine, meningioma and nerve sheath tumors originate from both the soft tissue coverings of the spinal cord or the attached nerves. Consequently, as these tumors grow, the spinal cord becomes compressed and its normal function is disrupted. In severe cases, patients will become gradually paraplegic or quadriplegic depending on the location of the lesion.

When treating benign spinal tumors with radiosurgery, the first objective is to stop all tumor growth. Longer term, the tumor will gradually shrink in size. Preliminary results with CyberKnife radiosurgery for meningioma and schwannoma show excellent control of tumor growth. Because tumor shrinkage occurs more slowly, it may not be the first choice for patients already experiencing neurological dysfunction due tumors exerting pressure on the spinal cord.

Stereotactic Radiosurgery for Malignant Tumors

Primary malignant tumors affecting the spine are relatively rare, and include tumors such as myeloma, lymphoma, osteosarcoma, and Ewing sarcoma. Generally, a combination of chemotherapy and radiation are recommended. In the case of isolated tumors, or tumors that recur following conventional treatment, radiosurgery is generally quite effective.

Low-grade tumors of the bony spine and spinal cord, such as chondrosarcoma, hemangioblastoma and ependymoma can be well-managed with CyberKnife spinal radiosurgery if the tumor is caught sufficiently early in its course, as can other, even more rare types depending on clinical evaluation.