medical

2. SPINAL CORD TUMORS
 Tumors within the spine are classified according to their anatomic
relation to the spinal cord.
 They include intramedullary lesions (within the spinal cord),
extramedullary-intradural lesions (within or under the spinal dura),
and extramedullary-extradural lesions (outside the dural membrane).

3.  Tumors occurring within the spinal cord or exerting pressure on it
cause symptoms ranging from localized or shooting pains and
weakness and loss of reflexes above the tumor level to progressive loss
of motor function and paralysis.
 Usually, sharp pain occurs in the area innervated by the spinal roots
that arise from the cord in the region of the tumor.
 In addition, increasing sensory deficits develop below the level of the
lesion.

4. Assessment and Diagnostic Findings
 Neurologic examination and diagnostic studies are used to make the
diagnosis.
 Neurologic examination includes assessment of pain, loss of reflexes,
loss of sensation or motor function, and the presence of weakness and
paralysis.
 Helpful diagnostic studies include x-rays, radionuclide bone scans,
and MRI.
 MRI is the most sensitive diagnostic tool and is particularly helpful in
detecting epidural spinal cord compression and vertebral bone
metastases.

5. Medical Management
 Treatment of specific intra spinal tumors depends on the type and
location of the tumor and the presenting symptoms and physical status
of the patient.
 Surgical intervention is the primary treatment for most spinal cord
tumors.
 Other treatment modalities include partial removal of the tumor,
decompression of the spinal cord, chemotherapy, and radiation
therapy, particularly for intramedullary tumors and metastatic lesions.

6.  Epidural spinal cord compression occurs in approximately 5% of
patients who die of cancer and is considered a neurologic emergency.
 In the patient with epidural spinal cord compression resulting from
metastatic cancer (most commonly from breast, prostate, or lung),
high-dose dexamethasone combined with radiation therapy is effective
in relieving pain.

7. SURGICAL MANAGEMENT
 Tumor removal is desirable but not always possible.
 The goal is to remove as much tumor as possible while sparing
uninvolved portions of the spinal cord.
 Microsurgical techniques have improved the prognosis for patients
with intramedullary tumors.
 Prognosis is related to the degree of neurologic impairment at the time
of surgery, the speed with which symptoms occurred, and the tumor
origin.
 Patients with extensive neurologic deficits before surgery usually do
not make significant functional recovery even after successful tumor
removal.

8. Nursing Management
 PROVIDING PREOPERATIVE CARE
 ASSESSING THE PATIENT AFTER SURGERY
 MANAGING PAIN
 MONITORING AND MANAGING POTENTIAL COMPLICATIONS
 Thanking you.