Spinal cord tumor For G.N.M 2nd & B.Sc.2nd & 3rd Year Nursing Student.

Musculo Skeletal Disorders For Nursing Student Under Medical Surgical Nursing For G.N.M & B.Sc. Nursing.

1. Spinal cord tumor Mr. Kush Joshi

2. DEFINATION Spinal cord tumor is a cancerous growth in the spinal cord which may be benign or malignant. If the tumor presses against the spinal cord or nerve roots urgent medical attention is needed as the compression of the nerves can lead to paralysis even if the tumor is benign.

3. Types of spinal cord tumor There are mainly two types of spinal cord tumor:- Primary spinal cord tumor secondary spinal cord tumor Tumors that start in spinal tissue are called primary spinal tumor. Tumors that spread to the spine from some other place (metastasis) are called secondary spinal tumors.

4. Causes and risk factors Exact cause is unknown Genetic defects may increase the risk of getting spinal cord tumor but research is being carried out into possible causes. Spinal cord tumors are much less common than brain tumors.

5. Clinical manifestations Symptoms are caused by pressure on the spinal cord and nerve roots. Pressure on the spinal cord may cause the following:- - Back and neck pain that progressively worsens - Numbness, tingling and weakness or paralysis in either the arms or legs or both - Decreased sensation

6. Loss of bladder and bowel control Difficulty in walking Muscles contractions or spasms Clumsiness ( poor coordination in movement or actions) Pressure on the spinal cord may also block the blood supply to the cord, resulting in death of tissues, fluid accumulation and swelling. Pressure on spinal nerve roots can cause pain, numbness, tingling, weakness in area supplied by the compressed nerve roots.

7. Diagnostic evaluation History collection and physical examination Neurological examination Special imaging techniques such as CT scan, MRI scan and positron emission tomography are also performed Biopsy ( an examination of tissues removed from a living body to discover the presence, causes or extent of a disease)

8. Spinal tap- lumbar puncture is also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid for diagnostic testing. It mainly helps to diagnose disease of central nervous system including brain and spine.

9. Management Surgery:- surgery may be needed to relieve compression on the spinal cord. Some tumors can be completely removed. In other cases, part of the tumor may be removed to relieve pressure on the spinal cord. A surgical technique called a decompressive laminectomy is sometimes performed to relieve pressure within spinal canal.

10. Radiotherapy:- radiotherapy uses high energy rays to destroy the cancer cells. Chemotherapy:- it include the use of cytotoxic drugs that destroy cancer cells. Ex., Azathioprine, bleomycin, irinotecan, lomustine and melphalan. ( cytotoxic drugs inhibit cell division and in this way cause cancer cells to die)

11. Nursing management Continuously assess patient’s neurologic status Monitor and record vital signs every 2 to 4 hourly or as ordered. Monitor ICP( intracranial pressure), use strict aseptic techniques.

12. Observe for signs of increased ICP:- decrease level of consciousness, restlessness, visual and other sensory disturbances, headache, vomiting, seizures and papilledema ( optic disc swelling due to increased intracranial pressure) Monitor intake and output chart Maintain the head of the bed at 15 to 30 degrees to reduce cerebral venous congestion. Maintain a quiet environment to increase patient’s pain tolerance.

13. Place patient in upright position to obtain greater lung expansion and improve aeration. Perform chest physiotherapy to remove mucus. Teach slow, pursed lip breathing to reduce airway obstruction Provide small, frequent meals that neutralize gastric secretion and may be better tolerated.

14. Thank you…