Here’s David’s explanation of what this next week involves for me and my little uninvited friend. The procedure will roughly follow these steps:
Step 1 (Day 1 – Monday): Starve
Vascular surgeon will try to cut off the blood supply to the tumor (tumor embolism) the day before the surgery by “zapping” the blood vessels feeding it.
Step 2 (Day 2 – Tuesday morning, 10am start): Stabilize
A surgeon will open her back to access the L1 vertebrae and the other vertebrae above and below. They will cut and remove a small piece of bone from L1 surrounding the spinal cord, which will relieve pressure on the spinal cord. They will then place two rods on either side of her spine and screw them in with pedicle screws. A CT scan will act as a reference for registering all the correct locations during the surgery to 3D image data. Holes for the screws are guided by an intra-operative navigation device by either Medtronic or BrainLab such that they can see three-dimensionally how the drill bit will go into the vertebrae to ensure that the screws are placed properly and don’t poke out the sides. They will then close her up on the back!
Step 3 (Day 2 – Tuesday evening): Remove
Flip ‘er over! They then flip her over on the operating room table and start again. This time, they make two incisions into her abdomen on either side of her belly button directed towards her L1 vertebra; this is to avoid scar tissue from her surgery six years ago and to provide good “vision” of the vertebrae and tumor from two sides. Once in there, they chew away at her discs above and below the L1 to free the vertebral body which is then removed. They then spend an indeterminate amount of time carefully removing yellowish-white tumor from yellowish-white healthy tissue and nerves. When that’s satisfied, they will put a titanium “cage” into the space where her L1 vertebrae once was, tighten it up, and expect bone cells to begin regrowth in the next few weeks. They then backout slowly stitching things up as they go, while of course exploring where her previous tumor resection took place (around the inferior vena cava) in an effort to remove as much tumor as possible.
Step 4 (Day 3 and on): Recovery
She then lays in bed for some time to heal, eat M&Ms, drink orange juice and takes pain meds! Six weeks of this and she’s ready to start chemotherapy and radiation…
Santa Monica-UCLA Medical Center and Orthopaedic Hospital is located at 1250 16th Street, Santa Monica, CA 90404.
To contact a patient at Santa Monica-UCLA Medical Center and Orthopaedic Hospital, please call the main operator at (310) 319-4000.
Clare & David