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Removing a tumor surgically is called surgical debulking. In most cases, the tumor must be removed in order to avoid pressure on the spinal cord or spinal nerves. Pressure or compression of the tumor on these tissues can cause major neurologic problems. Surgery may be needed to prevent paralysis.
The surgical team will use intraoperative monitoring (IOM) of spinal cord function to prevent further neurologic damage than is already present. Consistent use of IOM by the surgical team ensures good and constant communication between the monitoring and the surgical teams. This is the key to good success.
The monitoring team will alert the surgeon when a decline occurs in the function of the spinal cord. Changes can be made right away in how the procedure is being done. Sometimes a surgical instrument that's being used to pull some tissue out of the way is released for a short time. Or the surgeon looks for a better way to remove the tumor without traumatizing the spinal cord or spinal nerve roots.
Using IOM alerts the doctor to the risk of postoperative problems, including paralysis. But it doesn't identify who will have permanent damage. Paralysis may be present when some patients come out of recovery. Steroids are used to reduce the swelling and minimize these effects on the spinal cord. For some patients, only time will tell for sure how much function will be recovered.
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