Diagnosing Spinal Tumors: What Takes Other Hospitals Weeks — Penn Does in a Day

doctor looking at spinal cord xray

When a patient is suspected of having a spinal tumor, the clock starts to tick: We need an accurate, expedited diagnosis so treatment can begin," explains James Schuster, MD, Professor, Neurosurgery at Penn Medicine and Chief of Neurosurgery at Presbyterian Hospital. "If spinal cord compression is present, the situation is emergent and immediate intervention is needed to save a person's function or possibly — a life.

Penn is ready for any situation.

Streamlined, collaborative, multidisciplinary care

Spinal tumors present complex diagnostic issues. The Spinal Tumor Program at the Penn Spine Center offers referring physicians and patients the highest level multidisciplinary clinical expertise and a world-renowned research infrastructure to diagnose and treat metastatic as well as primary tumors.

A highly coordinated clinical team cares for each patient. Within a day or two, a patient meets with the Penn Spinal Tumor team for a diagnosis and a unique treatment plan. The team includes spinal surgeons, medical oncologists, radiation oncologists, urologists, plastic surgeons, neurologists, orthopaedic surgeons, gynecologists, urologists and vascular surgeons.

Although in person assessment is almost always necessary to determine the diagnosis and treatment course, the spine team facilitates as much care and follow-up visits as possible through advanced telemedicine.

The complicated cases come to Penn

Penn sees many spinal tumors that other physicians may see only once in a lifetime such as chordoma and various types of sarcoma. More commonly, spinal tumors are metastases from breast, lung, prostate, thyroid and renal cancer. "Penn's reservoir of clinical knowledge contributes to the diagnostic and treatment decisions for every patient," says Neil Malhotra, MD, Associate Professor, Neurosurgery at Penn Medicine and Chief of Neurosurgery at the Hospital of the University of Pennsylvania.

Dr. Schuster explains, "Penn physicians treat the hardest cases because we have the experience and depth of clinical expertise to handle them. A recent example was a patient who arrived at Penn for consideration of surgery to treat a primary spinal tumor. After our own rigorous diagnostic evaluation, we discovered that person had a metastatic tumor which required radiation — not surgery.

Some tumors extend beyond the spine into the bones or soft tissues of the chest wall, abdomen or pelvis. Coordination with other surgical experts at Penn is routine so all appropriate experts can weight in on individual cases and the ideal treatment plan can be enacted.

The power of Penn's advanced imaging

Knowing which imaging studies to perform, using the most advanced imaging techniques, and evaluating all the relevant data together is paramount for a correct diagnosis," Kristy L. Weber, MD, Chief, Orthopaedic Oncology and Director of the Sarcoma Program at Penn Medicine. Penn's musculoskeletal radiology team are experts in evaluating complex spine tumors and participate in our weekly multidisciplinary conference to discuss each individual patient.

Definitive data through biopsy and state-of-the-art diagnostics

In the right hands of experienced musculoskeletal radiologists, an image-guided biopsy is a safe and effective tool for attaining a correct diagnosis. Penn has perfected image-guided needle biopsy for spinal tumors, bringing years of successful experience to every case.

Other diagnostic modalities include cerebrospinal fluid examination cell studies of cerebrospinal fluid, myelogram, spinal CT, spinal MRI and spinal X-ray.

A treatment plan in place

For patients who need immediate surgery, Penn can mobilize a multidisciplinary team in hours, if needed. Penn neurosurgeons perform a large number of spinal tumor procedures each year pioneering new minimally invasive techniques and working with the latest technology to improve patient outcomes and quality of life.

Other treatment modalities include chemotherapy, immunotherapy, and radiation therapy, including Proton Therapy which may be used instead of, or in combination with, surgery.

In some cases, corticosteroids are used to reduce inflammation and swelling around the spinal cord.

Physical therapy and formal rehabilitation programs to improve muscle strength and the ability to function independently after treatment, is also offered.

For patients with recurrent disease who require new options, Penn's continuum of care includes a direct connection to a world-class roster of clinical trials and original research.

To schedule an appointment or receive a second opinion on your diagnosis, please call 215-662-3487.

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