Cáncer de columna vertebral

Spine cancer usually means there is a cancerous tumor in or around the spine bones, spinal cord, or nearby tissues—most often cancer that has spread (metastasized) from another part of the body. These tumors can weaken the bones, cause painful fractures, and press on nerves or the spinal cord, affecting movement and body control.​

1) What is this condition?

  • Cancer cells grow in the spine bones, spinal canal, or surrounding tissues; these may be primary (start in the spine) or, more commonly, metastatic (spread from cancers like breast, lung, prostate, kidney, or myeloma).​

  • Symptoms often include deep, persistent back or neck pain (especially at night), and if nerves are involved, numbness, weakness, or loss of bowel/bladder control.​

2) How serious is it?

  • Spine cancer is serious because it usually reflects advanced disease and can threaten the spinal cord, leading to paralysis if not treated promptly.​

  • However, modern treatments can often relieve pain, protect nerve function, and extend or improve quality of life, even when cure is not possible.​

3) Non‑surgical treatments

  • Radiation therapy:

    • Standard or focused (stereotactic radiosurgery/SBRT) radiation to shrink or control tumors, relieve pain, and protect nerve function.​

  • Systemic cancer treatments:

    • Chemotherapy, hormone therapy, targeted drugs, and immunotherapy aimed at the underlying cancer, which can also shrink or slow spine tumors.​

  • Medicines and bone support:

    • Pain medicines, steroids to reduce swelling around the cord, and bone‑strengthening drugs (bisphosphonates, denosumab) to reduce fracture risk.​

  • Bracing and rehab:

    • Back or neck braces to support weakened bones, plus physical and occupational therapy to maintain mobility and independence.​

4) Types of surgery that may be necessary

  • Decompression surgery: removing tumor and/or bone pressing on the spinal cord or nerves to relieve pressure.​

  • Stabilization/fusion: placing screws, rods, and sometimes cages or cement to reinforce weakened or fractured vertebrae.​

  • In select primary spine cancers or limited metastases, more aggressive removal (en bloc resection) may be attempted for longer‑term control.​

5) Goals of surgery vs non‑surgical care

  • Non‑surgical goals:

    • Control tumor growth or spread at the spine, relieve pain, and preserve function while avoiding the risks of major spine surgery when possible.​

    • Treat the underlying cancer throughout the body with systemic therapies.​

  • Surgery goals:

    • Quickly relieve dangerous spinal cord or nerve compression and stabilize the spine to prevent collapse or deformity.​

    • Improve or maintain the ability to walk and care for oneself, even when cure is not realistic.​

6) How surgery can “fix” the problem

  • Decompression removes tumor and bone that narrow the spinal canal or nerve openings, giving nerves and cord more room and better blood flow.​

  • Stabilization uses hardware and sometimes cement to rebuild a strong “bridge” across damaged bones, reducing pain with movement and preventing further collapse.​

  • Surgery is usually followed by radiation to control remaining tumor cells in the area.​

7) Risks of surgery (general and specific)

  • General risks: infection, bleeding (which can be significant in some spine tumors), blood clots, lung or heart problems, and anesthesia risks.​

  • Spine‑specific:

    • Nerve or spinal cord injury leading to new or worse weakness, numbness, or loss of bladder/bowel control.​

    • Hardware failure or non‑healing of the construct, sometimes requiring additional surgery.​

8) Chances this surgery will work

  • For metastatic spinal cord compression, decompression plus stabilization often leads to significant pain reduction and improved or preserved walking ability for most patients.​

  • Minimally invasive stabilization series report better mobility, better pain control, and high rates of discharge home compared with more extensive open surgeries in selected patients.​

  • Surgery is primarily palliative—its success is measured in pain relief and function, not cure—and is often combined with radiation and systemic therapy.​

9) Possible complications from the surgery

  • Wound infection or breakdown is relatively common in cancer patients, especially after large multi‑level surgeries.​

  • Persistent pain or neurologic decline in a minority of patients, despite technically adequate surgery.​

  • Medical complications (pneumonia, blood clots, urinary infections) due to immobility and underlying cancer.​

10) Typical recovery from the condition

  • Without treatment, spine cancer can lead to worsening pain, loss of mobility, and progressive neurologic decline.​

  • With modern combinations of systemic therapy, radiation, and selected surgery, many patients achieve substantial pain relief and maintain or regain the ability to walk and perform daily activities for much of their remaining life.​

11) Typical recovery after surgery

  • Hospital stays commonly last several days to a week or more, depending on the extent of surgery and other medical issues.​

  • Early mobilization with physical therapy is encouraged to reduce complications and restore function; many patients transition to inpatient or intensive outpatient rehab.​

  • Ongoing recovery includes radiation and systemic therapy, plus gradual increase in activity over weeks to months.​

12) How long in the hospital

  • Minimally invasive stabilization or limited decompression may require around 3–5 days in hospital if uncomplicated.​

  • Larger open reconstructions or complex medical situations may need longer stays and sometimes transfer to a rehab facility.​

13) Long‑term outlook

  • For metastatic spine cancer, prognosis mainly depends on the original cancer type, how far it has spread, and response to systemic treatment.​

  • Many patients live months to several years after spine involvement is found, with treatment focused on comfort, mobility, and quality of life.​

  • Primary spine cancers vary widely; some can be controlled long‑term with combined surgery and radiation.​

14) Need for outpatient follow‑up

  • Regular follow‑up with oncology, radiation oncology, and spine surgery to monitor tumor status, hardware, and neurologic function.​

  • Ongoing pain management, physical and occupational therapy, and sometimes palliative care to address symptoms and support daily living.​

  • Periodic imaging (MRI/CT, PET or bone scans when needed) to track spine lesions and detect new or progressing disease.