Treatments for Spinal Cord Tumor
Treatments for Spinal Cord Tumor
The list of treatments mentioned in various sources
for Spinal Cord Tumor
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Spinal Cord Tumor: Is the Diagnosis Correct?
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Differential diagnosis list for Spinal Cord Tumor may include:
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Drugs and Medications used to treat Spinal Cord Tumor:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Spinal Cord Tumor include:
- Carboplatin
- Paraplatin
- Paraplatin-AQ
- Blastocarb
- Carbotec
Hospitals & Medical Clinics: Spinal Cord Tumor
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More general information, not necessarily in relation to Spinal Cord Tumor,
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Medical news summaries about treatments for Spinal Cord Tumor:
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Discussion of treatments for Spinal Cord Tumor:
The three most commonly used treatments are surgery,
radiation, and chemotherapy. Doctors also may prescribe steroids to reduce
the swelling inside the CNS.
(Source: excerpt from
NINDS Brain and Spinal Tumors Information Page: NINDS)
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Treatments of Spinal Cord Tumor: Online Medical Books
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Low Back Pain/Swelling:
Treatment
(In a Page: Signs and Symptoms)
-
In absence of red flag symptoms, return to activity as soon as possible; rest has not been shown to improve recovery
-
Acetaminophen, NSAIDs, opioids, and/or muscle relaxants for pain; epidural corticosteroid injections may be indicated for resistant pain
-
Patient education (weight loss, exercise, proper back biomechanics and ergonomics)
-
Physical therapy, including pain relief modalities (ice, heat, ultrasound), stretching, strengthening, aerobic conditioning, and relaxation therapy
-
Surgery may be indicated for refractory disease, large neurologic deficits, unbearable pain, or significant limitations
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» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Scoliosis & Kyphosis:
Treatment
(In a Page: Signs and Symptoms)
- Scoliosis
–Treat underlying cause if applicable (e.g., tumor)
–<20–25° of deformity: Observation
–20–40° of deformity: Bracing (preferably to be worn 23 hours/day); bracing stops progression only; Milwaukee brace (includes neck ring) gives best results but poor compliance; lumbosacral orthosis (Boston brace) has poorer results but better compliance
–>40° of deformity: Surgery (posterior spinal fusion with rods) is usually indicated; progression is very likely
–More aggressive treatment is usually indicated if progression >5°, female, younger, or if secondary, treatment generally more aggressive - Kyphosis: Bracing or surgery, similar to scoliosis
>
>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Back Pain:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Muscular strain: Muscle relaxants, NSAIDs, rest, and reduction of exacerbating activities
-
-
-
Disk herniation: Physical therapy, surgery is rarely indicated in children and adolescents
-
Spondyloarthropathy: NSAIDs, exercise
-
Scoliosis: Conservative management with observation, NSAIDs, bracing or surgery if more severe
-
Gynocologic etiologies
–Menstrual cramps: NSAIDs, OCPs for severe cases
–PID: Appropriate cultures, treatment with antibiotics
–Endometriosis: hormonal therapy such as OCPs may
be effective, surgical ablation is rarely required
-
UTI: Antibiotics
-
Urolithiasis: Pain management followed by high fluid intake
-
Infection: Diskitis requires 4–6 weeks of IV antibiotics
-
-
-
Tumors: Referral to oncologist
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Scoliosis:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment options include observation while child is growing, bracing, and surgery
–Many curves do not progress enough to require treatment
–Spinal curve progression may occur despite bracing; however, for idiopathic scoliosis, response to brace wearing is dose-related and many patients do not like to wear the brace
-
Exercise and electrical stimulation have not been shown to alter natural progression of curve
-
Bracing for curves in 20–40° degree range may slow curve progression but does not reduce the magnitude of curve despite a well-made brace and compliance
-
Surgery is reserved for progressive curves >40° in skeletally immature (Risser scale 0–1) and >50° in skeletally mature patients
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Analgesia:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
Suspect spinal cord injury if the patient complains of unilateral or bilateral analgesia over a large body area, accompanied by paralysis. Immobilize his spine in proper alignment, using a cervical collar and a long backboard, if possible. If a collar or backboard isn’t available, position the patient in a supine position on a flat surface and place sandbags around his head, neck, and torso. Use correct technique and extreme caution when moving him to prevent exacerbating spinal injury. Continuously monitor respiratory rate and rhythm, and observe him for accessory muscle use because a complete lesion above the T6 level may cause diaphragmatic and intercostal muscle paralysis. Have an artificial airway and a handheld resuscitation bag on hand, and be prepared to initiate emergency resuscitation measures in case of respiratory failure.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Back pain:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient reports acute, severe back pain, quickly take his vital signs, and then perform a rapid evaluation to rule out life-threatening causes. Ask him when the pain began. Can he relate it to any causes? For example, did the pain occur after eating? After falling on the ice? Have the patient describe the pain. Is it burning, stabbing, throbbing, or aching? Is it constant or intermittent? Does it radiate to the buttocks or legs? Does he have leg weakness? Does the pain seem to originate in the abdomen and radiate to the back? Has he had a pain like this before? What makes it better or worse? Is it affected by activity or rest? Is it worse in the morning or evening? Does it wake him up? Typically, visceral-referred back pain is unaffected by activity and rest. In contrast, spondylogenic-referred back pain worsens with activity and improves with rest. Pain of neoplastic origin is usually relieved by walking and worsens at night.
If the patient describes deep lumbar pain unaffected by activity, palpate for a pulsating epigastric mass. If this sign is present, suspect a dissecting abdominal aortic aneurysm. Withhold food and fluid in anticipation of emergency surgery. Prepare for I.V. fluid replacement and oxygen administration. Monitor the patient's vital signs and peripheral pulses closely.
If the patient describes severe epigastric pain that radiates through the abdomen to the back, assess him for absent bowel sounds and for abdominal rigidity and tenderness. If these occur, suspect a perforated ulcer or acute pancreatitis. Start an I.V. for fluids and drugs, administer oxygen, and insert a nasogastric tube while withholding food.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Scoliosis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Only two treatments effectively treat scoliosis: spinal bracing and surgery. If monitored closely, a properly constructed and fitted brace can successfully halt progression of a curve in approximately 70% of cooperative patients. Most braces should be worn over a long T-shirt or similar article of clothing for 23 hours a day. However, mild curvatures may require less. Exercises must be done daily both in and out of the brace to maintain muscle strength. Patients should be seen for follow-up and brace adjustment every 3 months. Radiographs should be repeated at 6-month intervals. As the skeleton matures, as seen radiographically, brace wear should be gradually decreased until it’s worn only at night.
The primary indications for surgery are relentless curve progression (usually curves over 40°) or significant curve progression despite bracing. Surgery corrects lateral curvature by posterior spinal fusion and internal stabilization with metal rods. A distraction rod on the concave side of the curve “jacks” the spine into a straight position and provides an internal splint. An alternative procedure, anterior spinal fusion, corrects curvature with vertebral staples and an anterior stabilizing cable. Some spinal fusions may require postoperative immobilization in a brace. Postoperatively, periodic checkups are required for several months to monitor stability of the correction.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Malignant spinal neoplasms:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of spinal cord tumors generally includes decompression or radiation. Laminectomy is indicated for primary tumors that produce spinal cord or cauda equina compression; it isn't usually indicated for metastatic tumors. If the tumor is slowly progressive or if it's treated before the cord degenerates from compression, symptoms are likely to disappear, and complete restoration of function is possible. In a patient with metastatic carcinoma or lymphoma who suddenly experiences complete transverse myelitis with spinal shock, functional improvement is unlikely, even with treatment, and his outlook is ominous. If the patient has incomplete paraplegia of rapid onset, emergency surgical decompression may save cord function. Steroid therapy with dexamethasone minimizes cord edema and temporarily relieves symptoms until surgery can be performed. Partial removal of intramedullary gliomas, followed by radiation, may alleviate symptoms for a short time. Metastatic extradural tumors can be controlled with radiation, analgesics and, in the case of hormone-mediated tumors (breast and prostate), appropriate hormone therapy. Transcutaneous electrical nerve stimulation (TENS) may control radicular pain from spinal cord tumors and is a useful alternative to opioid analgesics. In TENS, an electrical charge is applied to the skin to stimulate large-diameter nerve fibers and thereby inhibit transmission of pain impulses through small-diameter nerve fibers. Chemotherapy generally hasn't proven effective against most spinal tumors, but may be recommended in some cases.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Analgesia:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Suspect spinal cord injury if the patient complains of unilateral or bilateral analgesia over a large body area, accompanied by paralysis. Immobilize his spine in proper alignment, using a cervical collar and a long backboard, if possible. If a collar or backboard isn’t available, place the patient in a supine position on a flat surface and place sandbags around his head, neck, and torso. Use correct technique and extreme caution when moving him to prevent exacerbating the spinal injury. Continuously monitor respiratory rate and rhythm, and observe him for accessory muscle use because a complete lesion above the T6 level may cause diaphragmatic and intercostal muscle paralysis. Have an artificial airway and a handheld resuscitation bag on hand, and be prepared to initiate emergency resuscitation measures in case of respiratory failure.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Back pain:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient reports acute, severe back pain, quickly take his vital signs; then perform a rapid evaluation to rule out life-threatening causes. Ask him when the pain began. Can he relate it to any causes? For example, did the pain occur after eating? After falling on the ice? Have the patient describe the pain. Is it burning, stabbing, throbbing, or aching? Is it constant or intermittent? Does it radiate to the buttocks or legs? Does he have leg weakness? Does the pain seem to originate in the abdomen and radiate to the back? Has he had a pain like this before? What makes it better or worse? Is it affected by activity or rest? Is it worse in the morning or evening? Does it wake him up? Typically, visceral-referred back pain is unaffected by activity and rest. In contrast, spondylogenic-referred back pain worsens with activity and improves with rest. Pain of neoplastic origin is usually relieved by walking and worsens at night.
If the patient describes deep lumbar pain unaffected by activity, palpate for a pulsating epigastric mass. If this sign is present, suspect dissecting abdominal aortic aneurysm. Withhold food and fluid in anticipation of emergency surgery. Prepare for I.V. fluid replacement and oxygen administration.
If the patient describes severe epigastric pain that radiates through the abdomen to the back, assess him for absent bowel sounds and for abdominal rigidity and tenderness. If these occur, suspect a perforated ulcer or acute pancreatitis. Start an I.V. line for fluids and drugs, administer oxygen, and insert a nasogastric tube while withholding food.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Scoliosis:
Treatment
(Handbook of Diseases)
The severity of the deformity and potential spine growth determine appropriate treatment, which may include such noninvasive measures as close observation, exercise, or a brace. For more serious deformity, surgery or a combination of methods may be needed. To be most effective, treatment should begin early, when spinal deformity is still subtle.
Noninvasive measures
A curve of less than 25 degrees is mild and can be monitored by X-rays and an examination every 3 months. An exercise program that includes sit-ups, pelvic tilts, spine hyperextension, push-ups, and breathing exercises may strengthen torso muscles and prevent curve progression. A heel lift also may help.
A curve of 25 to 39 degrees requires management with spinal exercises and a brace. (Transcutaneous electrical nerve stimulation may be used as an alternative.)
A brace halts progression in most patients but doesn’t reverse the established curvature. Such devices passively strengthen the patient’s spine by applying asymmetric pressure to skin, muscles, and ribs. Braces can be adjusted as the patient grows and can be worn until bone growth is complete.
Surgery
A curve of 40 degrees or more requires surgery (spinal fusion with instrumentation) because a lateral curve continues to progress at the rate of 1 degree a year even after skeletal maturity.
CLINICAL TIP: Some surgeons may prescribe Cotrel dynamic traction for 7 to 10 days for preoperative preparation. This traction consists of a belt-pulley-weight system. While in traction, the patient should exercise for 10 minutes every hour, increasing muscle strength while keeping the vertebral column immobile.
Surgery corrects lateral curvature by posterior spinal fusion and internal stabilization with a Harrington rod or other fixation devices. A distraction rod on the concave side of the curve “jacks” the spine into a straight position and provides an internal splint.
An alternative procedure, anterior spinal fusion with instrumentation, corrects curvature with vertebral staples and an anterior stabilizing cable. Some spinal fusions may require postoperative immobilization in a brace.
Postoperatively, periodic checkups are required for several months to monitor stability of the correction.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Spinal neoplasms:
Treatment
(Handbook of Diseases)
Spinal cord tumors usually require decompression or radiation. Laminectomy is indicated for primary tumors that produce spinal cord or cauda equina compression; it’s not usually indicated for metastatic tumors.
If the tumor is slowly progressive, or if it’s treated before the cord degenerates from compression, symptoms are likely to disappear, and complete restoration of function is possible. In a patient with metastatic carcinoma or lymphoma who suddenly experiences complete transverse myelitis with spinal shock, functional improvement is unlikely, even with treatment, and the outlook is ominous.
If the patient has incomplete paraplegia of rapid onset, emergency surgical decompression may save cord function. Steroid therapy minimizes cord edema until surgery can be performed. Partial removal of intramedullary gliomas, followed by radiation, may alleviate symptoms for a short time.
Metastatic extradural tumors can be controlled with radiation, analgesics and, in the case of hormone-mediated tumors (breast and prostate), appropriate hormone therapy.
Transcutaneous electrical nerve stimulation (TENS) may control radicular pain from spinal cord tumors and is a useful alternative to narcotic analgesics. In TENS, an electrical charge is applied to the skin to stimulate large-diameter nerve fibers and thereby inhibit transmission of pain impulses through small-diameter nerve fibers.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Spinal cord defects:
Treatment
(Handbook of Diseases)
Spina bifida occulta usually requires no treatment. Treatment of meningocele consists of surgical closure of the protruding sac and continual assessment of growth and development.
Treatment of myelomeningocele requires repair of the sac and supportive measures to promote independence and prevent further complications. Surgery doesn’t reverse neurologic deficits. A shunt may be needed to relieve associated hydrocephalus.
If the patient has a severe spinal defect, short- and long-term treatment will require a team approach, including a neurosurgeon, orthopedist, urologist, nurse, social worker, occupational and physical therapists, and parents.
Rehabilitation
In children or adults, rehabilitation measures may include:
❑ waist supports, long leg braces, walkers, crutches, and other ortho-pedic appliances
❑ diet and bowel training to manage fecal incontinence
❑ neurogenic bladder management to reduce urinary stasis, possibly intermittent catheterization, and antispasmodics, such as bethanechol or propantheline. In severe cases, insertion of an artificial urinary sphincter is often sucsuccessful; a urinary diversion is used as a last resort to preserve kidney function.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Analgesia:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Maintain spinal alignment during transport for laboratory or radiologic procedures. Monitor the patient’s vital signs and neurologic assessment closely. Provide continuous emotional support to the patient and his family.
Prevent pressure ulcer formation by such measures as meticulous skin care, massage, and frequent repositioning, especially when significant motor deficits hamper the patient’s movement. Guard against scalding by testing the water temperature before the patient bathes.
Patient teaching
Explain all tests and procedures. Advise the patient to test the water at home using a thermometer or a body part with intact sensation before showering or bathing.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Back pain:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Monitor the patient closely if the type and location of back pain suggest a life-threatening cause. Stay alert for increasing pain, altered neurovascular status in the legs, loss of bowel or bladder control, altered vital signs, sweating, and cyanosis.
Until a tentative diagnosis is made, withhold analgesics to avoid masking symptoms. Withhold food and fluids until it’s determined whether the patient requires surgery. Once a medical emergency is ruled out, make him as comfortable as possible by elevating the head of the bed, placing a pillow under his knees, and administering pain medications. Prepare the patient for a rectal or pelvic examination, routine blood tests, urinalysis, computed tomography scan, biopsies, and X-rays of the chest, abdomen, and spine.
Fit the patient for a corset or lumbosacral support. Refer him to a physical therapist, occupational therapist, massage therapist, or psychologist, as indicated.
Patient teaching
Explain all tests and procedures. Instruct the patient not to wear a lumbosacral support in bed. Describe such pain-relief measures as cold therapy, warm baths, mattress choices, and backboards. Instruct the patient and his family about relaxation techniques, such as deep breathing, biofeedback, and transcutaneous electrical nerve stimulation.
If the patient has chronic back pain, reinforce instructions about bed rest, analgesics, anti-inflammatory medications, and exercise. (See Exercises for chronic low back pain, page 41.) Help him recognize the need to make lifestyle changes, such as losing weight or correcting poor posture. Advise the patient with acute back pain secondary to a musculoskeletal problem to continue his daily activities as tolerated rather than staying on total bed rest.
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Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Back pain:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient has chronic back pain, reinforce instructions about bed rest, analgesics, anti-inflammatories, and exercise. Also, suggest that he take daily warm baths to help relieve pain. Help the patient recognize the need to make necessary lifestyle changes, such as losing weight or correcting poor posture. Advise patients with acute back pain secondary to a musculoskeletal problem to continue their daily activities as tolerated, rather than staying on total bed rest.
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Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Analgesia:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for spinal X-rays and imaging studies, and maintain spinal alignment and stability during the tests.
▪ Focus your care on preventing further injury to the patient because analgesia can mask injury or developing complications.
▪ Prevent formation of pressure ulcers through meticulous skin care and frequent repositioning, especially when significant motor deficits impair the patient's mobility.
▪ Guard against scalding by testing the patient's bath water temperature before he bathes.
Patient teaching
▪ Advise the patient to test bath water temperature at home using a thermometer or a body part with intact sensation.
▪ Explain all tests and procedures.
▪ Teach the patient about the diagnosis, once established, and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Back pain:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient closely if the back pain suggests a life-threatening cause.
▪ Be alert for increasing pain, altered neurovascular status in the legs, loss of bowel or bladder control, altered vital signs, sweating, and cyanosis.
▪ Withhold food and fluids in case surgery is necessary.
▪ Administer analgesics, as ordered, and evaluate their effect.
▪ Make the patient as comfortable as possible by elevating the head of the bed and placing a pillow under his knees.
▪ Encourage relaxation techniques such as deep breathing.
▪ Anticipate diagnostic testing, such as routine blood tests, urinalysis, a computed tomography scan, magnetic resonance imaging, appropriate biopsies, and X-rays of the chest, abdomen, and spine.
▪ Fit the patient for a corset or lumbosacral support.
▪ Provide heat or cold therapy, a backboard, a convoluted foam mattress, or pelvic traction, as ordered.
▪ Refer the patient to other professionals, such as a physical therapist, an occupational therapist, or a psychologist, if indicated.
Patient teaching
▪ Explain pain-relief measures to the patient.
▪ Teach him about alternatives to analgesic drug therapy, such as biofeedback and transcutaneous electrical nerve stimulation.
▪ Provide information about use of anti-inflammatory drugs and analgesics.
▪ Discuss lifestyle changes, such as weight loss or correcting posture.
▪ Teach relaxation techniques such as deep breathing.
▪ Instruct the patient on correct use of corset or lumbosacral support.
▪ Explain diagnostic tests and procedures.
▪ Teach the patient about the cause of his back pain and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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