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SPINAL CORD TUMOURS OIP (CLINICAL MANIFESTATIONS (Decreased sensitivity to…
SPINAL CORD TUMOURS
DEFINITION
Tumours developing within spinal canal/bones.
PATHOPHYSIOLOGY
Cancer can also spread through bloodstream.
Spinal tumour growth affects the:
Blood vessels
Nerve roots
Spinal vertebrae
Meninges
Spinal cord
Cancer spreads through subarachnoid cerebrospinal fluid.
Spinal cord gets compressed.
They can occur in the form of lymphoma.
This releases vast clinical manifestations.
Spinal cancer is a neoplasm in the spinal cord.
CAUSES
Environmental factors eg. exposure to toxic substances.
Inherited syndromes eg Neurofibromatosis.
Defective genes.
PHARMACOLOGICAL THERAPY
Corticosteroids reducing swelling postoperatively
Dexamethasone
Prednisone
CLINICAL MANIFESTATIONS
Decreased sensitivity to heat, cold and pain.
Difficulty in walking.
Back pain.
Muscle weakness.
Pain on tumour sight related to tumour growth.
Loss of bowel or bladder function
Back pain worsening at night.
Loss of motor function.
Loss of reflexes above tumour sight.
Paralysis
NURSING DIAGNOSIS
Peripheral neurovascular dysfunction.
Impaired urinary elimination.
Pain due to nerve compression.
Risk of injury related to surgery.
Anxiety due to surgery and post operation outcome.
NURSING INTERVENTIONS
Compensating for sensory impairment.
Facilitate about painful paraesthesia's.
Assess patient for sensory alterations.
Degree of sensory impairment decreases postoperatively.
Achieving good urinary continence.
Instruct patient on the intake of fluids.
Instruct patient to facilitate urinary elimination.
Assess the elimination patterns of patient.
Instruct patient to facilitate bowel elimination.
Relieving pain.
Health educate on relaxing techniques.
Facilitate breathing exercises.
Health educate client on the use of self-prescribed analgesics.
Position client off surgical site postoperatively.
Administer prescribed analgesia accordingly.
Additional postoperative care.
Instruct patient about dangers of extreme temperatures.
Refer neurofibromatosis patient to genetic counsellor.
Demonstrate proper positioning techniques.
Refer patient to cancer support groups.
Encourage use of adaptive devices with motor impairment.
Relieving anxiety.
Refer patient to cancer support groups.
Reduce environmental anxiety stimulation.
Properly explain all procedures to patient.
Provide resting periods to promote coping skills.
Create safe environment for patient to verbalise concerns.
COLLABORATIVE MANAGEMENT
Surgical removal of tumour.
Radiation therapy eliminating remnant tumours.
Posterior decompression of thoracic tumour through excision
Chemotherapy stopping growth of further tumours.
Anterior decompression of anterior tumours.
Acupuncture relieving nausea and vomiting.
TYPES OF SPINAL CORD TUMOURS
Gliomas
Cancers forming in glial cells.
Chordomas
Cancers forming and compressing the spine.
Medulloblastomas
Cancers originating from brain to the spine.
Schwannomas
Cancers starting inside the peripheral nerves.
Myeloma
Cancers of the bone marrow.
Meningiomas
Cancers starting around the spinal cord.
Leukemia
Cancers of the blood.
Metastatic
Cancers that have spread from lungs, breasts etc.
DIAGNOSTIC TESTS
CT myelography with lumbar puncture.
Biopsy determining exact type of tumour.
Computerised tomography detecting pathologic fracture.
Neurologic examination assessing:
Loss of reflexes.
Paralysis.
Loss of sensation.
Pain.
Loss of motor function.
Weakness.
Spinal magnetic resonance imaging for tumour detection.
