When is surgery needed for cervical myelopathy?

Surgery is generally recommended when spinal cord compression causes functional deficits like hand clumsiness or balance instability. Because the spinal cord has a limited ability to heal, early decompression is critical to prevent permanent disability.

Can cervical myelopathy worsen over time?

Yes. Clinical evidence suggests cervical myelopathy is often progressive, frequently following a 'step-wise' decline where neurological function does not return to baseline without surgical intervention.

What surgery is used to treat cervical myelopathy?

Surgical options depend on anatomy but commonly include Anterior Cervical Discectomy and Fusion (ACDF), Cervical Disc Replacement, or posterior approaches like Laminoplasty and Laminectomy with Fusion.

Is cervical myelopathy serious?

It is a serious condition involving spinal cord compression. Left untreated, it can lead to permanent loss of motor skills. Evaluation by a board-certified neurosurgeon like Dr. Hawasli is essential.

Spinal Tumor Surgery Kansas City | Ammar Hawasli MD PhD Neurosurgeon

Types of Spinal Tumors

Intramedullary TumorsThese tumors arise within the spinal cord itself. Examples include:

Ependymomas
Astrocytomas

Intradural Extramedullary TumorsThese occur inside the dura but outside the spinal cord. Examples include:

Meningiomas
Schwannomas
Neurofibromas

Extradural TumorsThese tumors occur outside the dura and often involve the vertebrae. Many are metastatic tumors that spread from cancers elsewhere in the body.

Symptoms of Spinal Tumors

Symptoms vary depending on the tumor’s location and size but may include:

Persistent back or neck pain
Pain radiating into the arms or legs
Weakness in the arms or legs
Numbness or tingling
Difficulty walking or maintaining balance
Changes in bowel or bladder function

Symptoms often develop gradually as the tumor compresses the spinal cord or spinal nerves.

How Spinal Tumors Are Diagnosed

Diagnosis typically includes:

Neurological examination
MRI imaging of the spine
CT scan in selected cases
Occasionally biopsy or surgical removal for diagnosis

MRI is the most important test because it allows detailed visualization of the spinal cord and surrounding structures.

Treatment of Spinal Tumors

Treatment depends on several factors including:

Tumor type
Tumor location
Symptoms
Whether the tumor is benign or malignant

Possible treatments include:

Surgical removal of the tumor
Radiation therapy
Observation for small benign tumors
Multidisciplinary cancer treatment when tumors originate elsewhere

When surgery is appropriate, the goal is to remove the tumor while preserving neurological function.

Spinal Tumor Surgery

Surgery for spinal tumors involves carefully removing the tumor and relieving pressure on the spinal cord or nerves. Advanced imaging and microsurgical techniques allow neurosurgeons to operate with precision while protecting surrounding neural structures.
Surgery may be recommended when:

The tumor is causing neurological symptoms
Imaging shows spinal cord compression
The tumor is growing
Tissue diagnosis is required

Consultation for Spinal Tumor Evaluation

Patients diagnosed with a spinal tumor or abnormal spinal MRI strongly benefit from evaluation by a neurosurgeon experienced in spinal tumor treatment.
Dr. Hawasli evaluates patients with spinal tumors and recommends surgical treatment when appropriate.