Different types of surgery are used for brain and spinal cord tumours.
Learn more about:
- Removing a brain tumour (craniotomy)
- Brain mapping
- Awake craniotomy
- Computer-assisted surgery
- Removing a pituitary tumour (endoscopic transsphenoidal surgery)
- Removing a spinal cord tumour (laminectomy)
Removing a brain tumour (craniotomy)
This is the most common type of brain tumour surgery. A craniotomy removes all or part of the tumour (total or partial resection) and may be done while you are asleep under general anaesthetic.
The surgeon cuts an area of bone (called the bone flap) from your skull to access the brain and remove the tumour. The bone is then put back and a small plate is screwed on to hold the piece of skull in place.
If you have a high-grade glioma, you may drink a solution before surgery to make the tumour glow under a special blue light. This helps the surgeon remove as much of the tumour as possible, while avoiding normal brain tissue.
For more on this, see our general section on Surgery.
Brain mapping
An electrode is placed on the outside layer of the brain to stimulate and pinpoint important areas of the brain. Brain mapping may be done during surgery, or as part of an awake craniotomy.
Awake craniotomy
This operation may be recommended if the tumour is near parts of the brain that control speech or movement. You are usually put to sleep (general anaesthetic) and are later woken up but relaxed (conscious) for part of the operation.
The surgeon asks you to speak or move parts of your body to identify and avoid damaging those parts of the brain.
You may be worried that an awake craniotomy will be painful, but the brain itself does not feel pain and local anaesthetic is used to numb surrounding tissues.
Computer-guided surgery
It is now usual for a craniotomy to be done using a computer system to guide the surgeon. This is known as stereotactic surgery.
The computer uses the results of planning scans to create three‑dimensional images of the brain and tumour. During the operation, the computer monitors the position of the surgical instruments, allowing the surgeon to be very precise.
Stereotactic surgery is safer, more accurate and requires a smaller cut in the skull than non-computer‑guided surgery.
Removing a pituitary tumour (endoscopic transsphenoidal surgery)
The most common surgery for pituitary gland tumours (and other tumours located near the base of the brain) is called endoscopic transsphenoidal surgery.
To remove the tumour, the surgeon inserts a long, thin tube with a light and camera (called an endoscope) through the nose and into the skull at the base of the brain. An ear, nose and throat (ENT) surgeon may also assist with this type of surgery. You will be given a general anaesthetic for this operation.
Removing a spinal cord tumour (laminectomy)
The most common surgery for spinal cord tumours is a laminectomy. The surgeon makes an opening through the skin, muscle and a vertebra in the spinal column to remove the tumour. You usually have a general anaesthetic for this type of surgery.
Some spinal cord tumours may also need surgery to the spinal cord itself. Your surgeon will talk to you about this particular surgery, as it may have a risk of nerve or spinal cord injury.
→ READ MORE: What to expect after surgery
Podcast: Making Treatment Decisions
Listen to more episodes from our podcast for people affected by cancer
More resources
Prof Lindy Jeffree, Director of Neurosurgery, Alfred Health, VIC; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Prof Tamara Ownsworth, Clinical Neuropsychologist and Research Director, The Hopkins Centre, Griffith University, QLD; A/Prof Hao-Wen Sim, Medical Oncologist, The Kinghorn Cancer Centre and Chris O’Brien Lifehouse, NSW; Megan Trevethan, Clinical Specialist Occupational Therapy – Cancer and Lymphoedema Services, Princess Alexandra Hospital, QLD; Chris Twyford, Cancer Specialist Nurse, Canberra Health Services, Cancer and Ambulatory Support, ACT; Dr Adam Wells, Clinical Academic Consultant Neurosurgeon, The University of Adelaide, Royal Adelaide Hospital, SA.
View the Cancer Council NSW editorial policy.
