UCSF Spine Center Tackles Most Complex Spine Surgeries on West Coast
A UCSF surgical team successfully removed a large cancerous tumor in a single piece from the cervical spine of a patient in 12 hours — a procedure that is believed to be the first of its kind in complexity and to have taken place in record time.
Most important, the procedure provides the patient with the possibility of total elimination of the cancer.
Called an en bloc resection, the procedure takes its name from the removal of tissue as a whole (en bloc), rather than piecemeal. The seven-centimeter tumor spanned four neck vertebrae — C3, C4, C5 and C6 — and was removed by a team of two UCSF surgical specialists.
In peer-reviewed medical literature, there are reports of two patient cases of tumor removal involving three cervical vertebrae, and these procedures each took approximately 40 hours. In a medical journal in the future, the UCSF team plans to report its experience in performing the four-vertebrae procedure.
An en bloc resection is technically challenging, according to the UCSF team, but for certain types of tumors, it provides the patient with the only real chance at a cure. In the past, these tumors were removed in pieces, which left significant tumor tissue and led to recurrence. En bloc resection patients have a better chance at eradication of the cancer, the medical team said.
“The short operation time and successful outcome are the result of a willing patient, a professional medical team and a multidisciplinary approach between neuro- and orthopaedic surgery,” said UCSF neurosurgeon Christopher Ames, MD, director of spinal tumor and deformity surgery, Department of Neurological Surgery, who performed the surgery along with Vedat Deviren, MD, Department of Orthopaedic Surgery.
The UCSF Spine Center is the only center on the West Coast that routinely performs extremely complex procedures that involve the spine. Per year, the center performs from 10 to 15 en bloc resections and treats about 300 patients, who have come to UCSF from around the world.
Their medical problems include spinal deformity, degenerative diseases of the spine, herniated discs, lumbar vertebral displacement (spondylolisthesis), spinal tumors, acute fractures and trauma to the spine, infections, neck and low-back disorders, osteoarthritis, and rheumatoid arthritis affecting the cervical, thoracic and lumbar spine.
“We have been treating extremely complex cases with minimal morbidity,” said Deviren, associate professor in clinical orthopaedics at UCSF. “The four-vertebrae en bloc procedure is just one of the tremendously complex surgeries that we performed over the year. I am very pleased with our multidisciplinary approaches and results.”