NEUROSURGERY ARTICLES

CYBERKNIFE STEREOTACTIC RADIOSURGERY FOR SPINAL TUMORS

by Laura Paré, M.D.

Prior to the development of radiosurgery for spinal tumors, conventional radiation therapy was used and resulted in large radiation doses being given to important normal tissues located near the tumor, such as the spinal cord and nerves. Radiosurgery is the process by which a tumor can be precisely and completely destroyed using high tumorkilling doses of radiation without significantly damaging the surrounding normal tissues. One of the most accurate methods of treating spinal tumors with radiosurgery is by using the Cyberknife® (Accuray, Inc., Sunnyvale, CA). The Cyberknife® was approved by the US Food and Drug Administration in 2001 for use on the spine.

Spinal tumors can be either benign or malignant. In order to determine whether a patient is a candidate for Cyberknife® radiosurgery, they must first consult with a neurosurgeon and then a radiation oncologist who have special training in radiosurgery and Cyberknife® technology. Then the patient will need small, 3-4 mm, metal markers called fiducials to be implanted into the spine in the region of the tumor during a short, outpatient surgery. The fiducials are implanted using minimally invasive spinal surgery techniques.

Next, the patient undergoes a CT scan and an MRI scan of the spinal tumor after the fiducials are implanted. The neurosurgeon, radiation oncologist, and radiation physicist, together, then plan the radiosurgery treatment using the CT scan, MRI scan, and sophisticated computer software that allows the maximum dose of radiation to be given to the tumor in a very accurate fashion, while minimizing the radiation dose to the spinal cord, nerves, and other important tissues nearby.

Finally, the patient comes to the Cyberknife® Center and undergoes the radiosurgery treatment as an outpatient. The patient lies comfortably on a special table at the Cyberknife® Center while the treatment is given. Treatments generally last from 30 minutes to 2 hours, and are given in one to three sessions depending on the size and complexity of the tumor being treated. During the treatment, x-rays are taken of the spine and the fiducials frequently. This allows the computer program to compensate for any movements of the patient during the treatment to maintain maximal accuracy during radiosurgical treatment. Spinal radiosurgery is well-tolerated by most patients.

For information about the Cyberknife® here in Orange County, log onto www.newportdiagnosticcenter.com/cyberknife.html. For more information about Cyberknife® in general, log onto www.accuray.com.

University of California, Irvine • Irvine, CA 92697
(949) 824-5011
© 2006 The Regents of the University of California.
All Rights Reserved.

Comments & Questions: Privacy & Legal Notice
Copyright Inquiries