Against All Odds: A Mom Walks Again After Two Spinal Tumor Surgeries

At 21, Desiree was a mom with a 4-year-old son. She had a steady job as a waitress, and she spent her spare time with her family. She was healthy and active—until she started to feel discomfort in her ankle, which kept getting worse. “I fractured my ankle when I was younger. So, I didn’t think much about it when I first felt that dull ache,” says Desiree, now 23. “But then, the pain started to get worse. It spread to my legs and my pelvis. By the time I saw a doctor, I could barely walk. I had balance issues, and I would trip and fall without even knowing how it all happened.”

With a heavy workload and other responsibilities, Desiree delayed seeking care. Eventually, the pain, numbness in her leg and prickly sensations in her feet became too much. She finally saw a doctor in Athens, Georgia, in July 2022. CT scans and MRIs revealed a grapefruit-size mass pressing on the nerves in her lower back.

Her doctor diagnosed her with chondrosarcoma—a rare, cancerous bone tumor—on her spine and referred her in August to Emory Healthcare for care at Winship Cancer Institute of Emory University and with the Emory Brain Health Center’s neurosurgery team.

Winship Cancer Institute is Georgia’s only National Cancer Institute-designated Cancer Center, which means it meets rigorous standards when it comes to the prevention, diagnosis and treatment of cancer. Desiree's care would also be supported by the Emory Brain Health Center’s neurosurgery services at Emory University Hospital—giving her a comprehensive cancer and neurosurgery team.

Leading that team was Daniel Refai, MD, an Emory Healthcare neurosurgeon who specializes in spinal oncology and is a cancer prevention and control researcher at Winship Cancer Institute. Since 2012, he has performed most of Emory’s primary spinal tumor surgeries, which are tumors that originate in the spine versus spreading from other parts of the body. He and his collaborative team, which includes neurosurgeons, medical oncologists and radiation oncologists, used advanced techniques and tools to remove Desiree’s cancer and help her walk again.

Chondrosarcoma is the third most common primary bone tumor. It starts in the bone rather than being caused by another type of cancer. Most chondrosarcomas develop in men and typically appear in patients between the ages of 60 and 70.

“As a young woman, it’s extremely rare for Desiree to be diagnosed with a lumbar chondrosarcoma—a cancerous bone tumor in her lower back,” says Dr. Refai, who also serves as Emory Healthcare’s vice chair of neurosurgery.

In addition to being uncommon, Desiree’s cancer was aggressive. Her tumor pressed on and covered the entire psoas muscle on the left side of her body. This muscle runs along the back of the spine to the hip and controls hip flexion movements like getting up from a chair or walking up stairs. Desiree’s tumor also squeezed the nerves in her spine, causing numbness and making her leg weak.

Dr. Refai ordered another MRI to help him identify the best way to treat Desiree’s cancer. When he realized the tumor had grown larger in only a month, he knew surgery to remove the entire mass was her only option.

“It was alarming. In only one month, her tumor had gotten bigger. We had to remove her psoas muscle and the tumor,” he says. “I told Desiree I was concerned that she may lose complete function and feeling in her leg. There was a 50-50 chance that she may never walk again. But the chances were 100% if she didn’t have the surgery.” 

Dr. Refai partnered with Winship sarcoma surgeon Kenneth Cardona, MD, FACS, to remove Desiree’s tumor at Emory University Hospital Midtown. Their goal was to completely remove the cancer without creating instability in her spine that they would need to fix with rods and screws.

The surgery was straightforward. The team made a small incision on Desiree’s left side and used precision tools to remove her psoas muscle, the tumor and the damaged nerves. According to Dr. Refai, the procedure was a success. No rods or screws were needed.

“The surgery went great. After the procedure, Desiree could wiggle her toes and foot, and she was determined to complete physical therapy and walk again,” he says. “Everything looked great until we got our post-operative CT scan. A little fragment of tumor remained from where the mass grew into her spinal canal before surgery.”

That tiny bit of tumor meant Desiree had to postpone proton beam radiation, the next phase of her treatment. She needed another surgery. Without it, her cancer had a high likelihood of returning. Despite the setback, Desiree stayed upbeat and motivated.

“I knew this was a long process and that recovery was going to be hard work. But it didn’t bother me to have another surgery,” she says. “I just wanted to do whatever it took to get healthy and get back home to my baby.”

That meant Desiree was back in the operating room three weeks later. This time, Dr. Refai made an incision in her back. Using a drill and image guidance, he removed half of the L4 vertebrae in her lower back to get the final piece of the tumor. He implanted several 4.5 cm screws to stabilize her spine. 

Although a post-surgery MRI showed the tumor was gone, Desiree underwent eight weeks of daily proton beam therapy, a thin ray of radiation often paired with surgery to treat cancer and prevent it from returning, at Winship’s Emory Proton Therapy Center, which is the only proton center in Georgia. Then, her long journey back to mobility began.

She says she spent several months in physical therapy learning to walk again. Today, she has some limitations and wears a brace.

“Even though I can’t run, bend or crouch down, and I need time to recover after an hour or two of activity, I appreciate everything that was done for me,” she says. “I might not walk the same way I used to, but I can walk and play with my son.”

Desiree says she and her family are grateful for Dr. Refai’s expertise and the exceptional care she received from his team. They gave her a chance to be the mom she wants to be.

“My son didn’t really understand what was going on with me. So, we just called my tumor the monster,” she says. “During one of my appointments, he looked at Dr. Refai and said, ‘Thank you for taking the monster out of my mommy.’ He can tell a real difference in how Mommy is now.” 

Learn more about sarcoma care at Winship Cancer Institute of Emory University. Call 404-778-1900 for a cancer care appointment.

To reach a member of our neurosurgical team, call 404-778-5770.