Groundbreaking Surgery: Spinal Tumor Removed Through Eye Socket for the First Time

In an unprecedented breakthrough in neurosurgery, a medical team at the University of Maryland Medical Center (UMMC) successfully removed a spinal tumor through a patient's eye socket, marking the first time a transorbital procedure has been used to treat spinal cancer.

The patient, 19-year-old Karla Flores, was diagnosed with a chordoma, a rare bone tumor that developed at the base of her skull and extended around her spinal cord. Due to the tumor's delicate and critical location, traditional surgical approaches posed significant risks, including paralysis or death. To avoid these dangers, neurosurgeon Dr. Mohamed Labib and his team devised an innovative surgical pathway through the eye socket, creating a “surgical corridor” that allowed access to the tumor without damaging vital structures like the brainstem or major blood vessels.

The surgery lasted approximately 19 hours and involved the collaboration of specialists in neurosurgery, facial reconstructive surgery, and otolaryngology. Dr. Kalpesh Vakharia, the facial reconstructive surgeon, performed precise incisions inside the lower eyelid and mouth, removing parts of the orbital bone and cheekbone to reach the tumor. He later reconstructed the eye socket using a titanium plate and bone from the patient’s hip.

In addition to removing the spinal tumor, Flores underwent two more procedures to eliminate another chordoma encasing her brainstem. These were performed using endoscopic techniques through the skull and nose. Following the surgeries, she received proton beam radiation therapy to destroy any remaining cancer cells and underwent a spinal fusion to stabilize her cervical spine.

Currently, Flores is in recovery and experiencing some difficulty moving her left eye due to nerve damage caused by the tumor. Nevertheless, her prognosis is favorable, and she plans to continue her studies to become a manicurist.

This groundbreaking case underscores the importance of innovation and multidisciplinary collaboration in modern medicine. It opens new avenues for treating hard-to-reach tumors and offers hope to patients facing similarly complex conditions.