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Alcohol to cure spinal tumours

New Delhi: Doctors have now come out with a new `high` in alcohol use — treating spinal tumours. The All India Institute of Medical Sciences (AIIMS) has successfully treated over 30 patients suffering from Vertebral Hemangiomas – an uncommon type of spinal tumor- using alcohol which is injected to reduce the blood supply to the tumor cells and subsequently kill them.

Dr P Sarat Chandra, Associate Professor in Department of Neurosurgery, said they first used the technique in ten patients. After getting encouraging results, another 20 patients received the same treatment, which is not only less tedious and gives better results but is also far cheaper than the conventional method.

Citing reasons for using alcohol for the treatment of this spinal cord tumor, Chandra said, "It is doubly advantageous."

Alcohol (absolute ethanol) is the most effective and inexpensive blood clogging (embolizing) material available at a cost of Rs 20 or 30 in comparison to a Rs two or three lakh required for conventional embolization.

The toxicity in alcohol is enough to kill the tumor cells and later encourages new normal bone formation, he said.

Treatment of such tumors includes first stopping of small blood vessels and blocking the flow of blood to a tumor. This allows the surgeon to remove the tumor compressing the spinal cord safely without any risk of bleeding.

"This is followed by placement of rod and screws to prevent fractures and allow bone fusion.

"If we go back to history of medicine, alcohol was perhaps the most effective embolizing agent and was first used to treat a type of kidney tumor," Chandra said, adding, "it was also later used to treat vertebral hemangiomas by injecting them through the skin directly".

The procedure was, however, given up due to certain complications like fractures of spine and causing cardiac instability.

"However, we have reused the same technique by first injecting the alcohol and then performing spinal stabilization in the same sitting to prevent fractures.

"To avoid any cardiac complications due to the toxic nature of alcohol, what we did is inject it in little quantity at regular time interval under careful monitoring," he said.

A K Mahapatra, professor of neurosurgery, AIIMS said, "These tumor are extremely vascular (filled with blood), and surgery would be a disaster and fatal for the patient unless the blood supply is reduced. You touch them and they start bleeding."

The conventional embolization procedures are very tedious and so expensive that it is often beyond the reach of common man.

Mahapatra said, "In the conventional method of embolization the neuro radiologist will do an angiogram and through one blood vessel pass some tube to reach the tumor and inject a glue to all the blood vessels that supply blood to that tumor after which the surgeon can go ahead and remove the tumor".

This is too tedious a process and the instruments needed and the glue too cost more than a lakh. The glue also does not kill the tumor cells in areas not accessible by surgery which alcohol does.

Chandra said, "Using alcohol the treatment of this disease has become affordable and equally effective.

"Our experience has been very encouraging and we have seen patients improve very significantly even in those who were paraplegic (complete weakness)," he said

The work has been published in the noted international journal called `Neurosurgery`.

"We just reinvented the wheel by introducing a forgotten procedure with some indigenous modifications allowing this to become a very effective procedure," he said, adding "it is very relevant technique for a country like ours with limited financial resources.

"It is equally important that we do not give completely the earlier technologies as they have been introduced after a lot of thinking. What we need to do is to modify, reinvent and reapply it," he said.

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