Specialty surgeon complete packaged procedure for intra-dural spinal surgery with an implant. The treatment for most intramedullary and intradural-extramedullary spinal tumors is surgical excision. The goal is the total removal of the tumor with maximal preservation of neurological function. Most intradural-extramedullary tumors are amenable to total resection with minimal or no neurological problems postoperatively. Large filum terminal ependymomas may often be impossible to totally remove since they adhere to many spinal nerves.
Post-operative radiation therapy may improve outcomes in these cases. Intramedullary ependymomas and hemangioblastomas are usually well-differentiated from the surrounding spinal cord and can often be removed completely. Operative therapy may consist of removal of the portion of the vertebra involved with the tumor to decompress the spinal cord and placement of acrylic or banked bone and metallic implants to preserve the stability of the spine. Benign tumors of the spinal column can often be totally removed. The fusion of the spine with bone grafts and metallic implants may be necessary to preserve spinal stability in these cases.
Patients often have temporary neurological problems postoperatively, however, these often resolve. Intramedullary astrocytomas blend in with the surrounding spinal cord and are thus difficult to remove completely. Since these tumors are usually slow-growing, patients may still experience a significant benefit from subtotal removal.
In an intra-dural spinal surgery with an implant, the treatment cost includes the facility fee, physician’s fee, related medical procedures, and drugs required to administer the plan of care. Not included are diagnostic studies, consultations with additional specialists, and cost of complication management; travel, food, and lodging.