7/22/2010 -For a cancer patient with only a short time to live, one of the worst ways to spend those remaining years is with excruciating and debilitating back pain.
But as cancer survivorship has improved, the instances of the cancer metastasizing, or spreading, to the spine has increased, and more surgical interventions are necessary to repair the damage and alleviate the 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.
For more information, visit www.vanderbilthealth.com/spinecenter.©2013 Vanderbilt University Medical Center