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Surgical considerations of spinal ependymomas in the pediatric population
Wesley Hsu1, Gustavo Pradilla, Shlomi Constantini
1Department of Neurosurgery, The Johns Hopkins University School of Medicine, Meyer Bldg. 8-161, 600 N. Wolfe St., Baltimore, MD 21287, USA. weshsu@jhmi.edu
Insights
This review covers pediatric intramedullary spinal cord ependymomas, emphasizing gross total resection as the primary treatment. Surgical techniques and outcomes are detailed for managing these rare pediatric tumors.
Area of Science:
- Pediatric neurosurgery
- Pediatric oncology
- Spinal cord tumors
Background:
- Spinal ependymoma is the second most common pediatric spinal cord tumor.
- Gross total resection is the gold standard treatment.
- Adjuvant radiation may benefit patients with residual tumor.
Purpose of the Study:
- To review current management strategies for pediatric intramedullary spinal cord ependymomas.
- To discuss clinical evaluation, surgical techniques, and postoperative care.
- To outline long-term outcomes and potential complications.
Main Methods:
- Literature review of current management strategies.
- Discussion of clinical presentation and diagnostic workup.
- Analysis of surgical techniques and postoperative care protocols.
Main Results:
- Gross total resection is the primary goal for pediatric spinal ependymomas.
- Intraoperative monitoring is crucial for minimizing neurological deficits.
- Multilevel laminectomy may necessitate spinal stabilization.
Conclusions:
- Optimal surgical resection is key for favorable outcomes in pediatric spinal ependymomas.
- Careful postoperative management is essential for recovery.
- Spinal stabilization techniques can prevent deformity after extensive surgery.
Objectives:
The objective of this manuscript is to discuss current management strategies regarding pediatric patients with intramedullary spinal cord ependymomas. Spinal ependymoma is the second most common spinal cord tumor in children. The clinical evaluation of these patients, operative techniques, postoperative management considerations, and long-term outcomes are discussed.
Introduction:
The gold standard for the treatment of spinal ependymoma continues to be gross total resection. Patients with residual tumor postoperatively may benefit from adjuvant radiation therapy. Intraoperative monitoring is critical to minimize permanent postoperative neurologic deficit.
Conclusion:
Patients requiring multilevel laminectomy may benefit from concomitant laminoplasty or instrumented fusion to avoid progressive spinal column deformity.
