From spinal cord surgery to half marathons
Young X-ray technologist gains new lease on life
June 14, 2013
Jorge Partida was only 23 when he sat in an exam room at UC Irvine Medical Center and listened — incredulous — as the physician explained the numbness in his right hand and leg.
Dr. Daniel Yanni, a neurosurgeon and director of the UC Irvine Health comprehensive spine neurosurgery service, told Partida that he had a huge — and rare — tumor in his spinal cord.
Removing it would involve serious risks, including possible paralysis. Left alone, however, the tumor would continue to grow, eventually killing him by making it impossible for Partida to eat, speak and breathe.
"Dr. Yanni said, 'Jorge, I'm going to be honest with you. Right now you're going to hear more bad news than good,'" Partida recalls.
Yanni told Partida and his family to take some time to consider the diagnosis. When he returned in a few hours, the physician was carrying the surgery permission forms.
"He knew and I knew what we had to do," says Partida, now 25. "I was really scared. But Yanni said, 'You're going to make it. I know what I'm doing.' "
Partida is grateful that the staff at an urgent care center, where he initially went for help with baffling symptoms, referred him to UC Irvine Medical Center, home to one of the most highly skilled neurosurgical services in the state. Unlike many smaller or community hospitals, it has the critical expertise needed to treat rare spinal tumors like Partida's.
Experience counts with such rare complex tumors, UC Irvine Health experts say.
Spinal tumors come in a variety of forms. Some are cancers that have spread from elsewhere in the body, such as the lung or breast. These tumors are typically treated with surgery followed by chemotherapy and radiation. Another type of tumor, typically non-cancerous but still dangerous, grows within the spinal canal. These growths, known as meningiomas or schwannomas, require delicate microsurgery to remove.
A third, even rarer tumor, called an intramedullary ependymoma, grows inside the actual spinal cord.
As these tumors grow larger, they push things out of the way. Sometimes these tumors develop a syrinx, a fluid-filled cavity within the spinal cord that can cause weakness and atrophy in the hands and trouble walking. That's what happened to Partida.
An X-ray technician who lives in Costa Mesa, Partida began noticing occasional numbness in his right hand about five years ago. By 2011, the numbness was occurring in his right foot, too. One afternoon, after taking a nap before his evening work shift, he awoke to find he'd lost all feeling in his right foot.
"It was completely asleep," Partida recalls. "I drove to work like that. I figured it would just go away. It never did."
Reluctant to go to a doctor, Jorge eventually felt the numbness spread to his leg. But when Partida began having blurry vision and spells where he thought he was going to pass out, he went to an urgent care center. He was referred to UC Irvine Medical Center and, within a week, he underwent the seven-hour operation to remove the tumor. Called an ependymoma, it was wedged in the spinal cord from his neck down to about the level of his upper chest.
"This was a very complex tumor in a critically important section of the spine," Yanni recalls, "with a massive, fluid-filled cavity above and below the tumor."
The risk of operating on such a tumor was extremely high, Yanni says, "But this is what I'm trained to do. I have experience operating on these tumors and we have a great, multidisciplinary team at UC Irvine Health. All of Jorge's care was done by us — from start to finish."
Advances in neurosurgery techniques and imaging make it possible to complete operations such as Partida's. The medical center has two state-of-the-art operating rooms where angiograms and CT scans can be performed during surgery.
Surgeons also have perfected microsurgical techniques that require smaller incisions and result in more precise removal of tumors. Moreover, they are able to stimulate the spinal cord during surgery — a process called dorsal column mapping — to select the best places to work while minimizing nerve damage, says Yanni, author of a 2010 paper describing the technique in the Journal of Neurosurgery: Spine.
These advances allow surgeons to remove tumors that at one time were considered inoperable.
New treatments for tumors
For malignant tumors, there also are numerous new therapies, including treatments that can cut off the blood supply to the mass and highly focused radiation that minimizes side effects.
The medical center also has Orange County's only neurological intensive care unit, where patients recovering from spine tumor and other neurological surgeries receive specialized care. Healthcare workers in this unit are board-certified in the care of complex conditions of the brain and central nervous system.
About 36 hours after his spine tumor surgery, Partida awoke and realized he could wiggle his toes — that he wouldn't be paralyzed. "I got teary," he says, recalling the moment.
With an incision that ran from his hairline to the middle of his back, Partida needed almost a full year of rest and physical therapy to resume his normal activities. He's done that and more. He even ran in the Orange County Marathon, completing the half marathon course on May 5. He was eager to tell his neurosurgeon about it at his next check-up.
"I couldn't be happier with how he's doing," says Yanni. "Two years out, his MRI shows zero recurrence of the tumor and zero residual tumor. We have cured him."