Resection of a Pediatric Intramedullary Spinal Cord Tumor: 2-Dimensional Operative Video.

Area of Science:

• Neurosurgery
• Pediatric Oncology
• Spinal Surgery

Background:

• Pediatric intramedullary spinal cord tumors (IMSCTs) can cause significant morbidity.
• Aggressive surgical resection is linked to improved long-term outcomes for IMSCTs.
• Early diagnosis and intervention are crucial for managing spinal cord compression and neurological deficits.

Purpose of the Study:

• To present a case and surgical technique for pediatric IMSCT resection.
• To highlight the importance of microsurgical techniques and intraoperative monitoring.
• To demonstrate the feasibility of gross total resection in a challenging pediatric case.

Main Methods:

• Case presentation of a 13-year-old male with progressive scoliosis and a T6-7 spinal cord lesion.
• Surgical approach involving T5-T8 osteoplastic laminectomies and tumor resection.
• Utilized intraoperative ultrasound, neuromonitoring (SSEPs/MEPs), and ultrasonic aspirator for gross total resection.

Main Results:

• Gross total resection of the presumed pilocytic astrocytoma was achieved.
• Postoperative MRI confirmed complete tumor removal with no residual enhancement.
• The patient showed good neurological recovery, with stable imaging at 2-month follow-up.

Conclusions:

• Aggressive microsurgical debulking is effective for pediatric IMSCTs.
• Intraoperative monitoring and advanced surgical tools facilitate safe and complete tumor resection.
• Favorable neurological outcomes can be achieved with timely and thorough surgical intervention.