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Intraspinal tumors in children. A review of 81 cases
Insights
This study analyzed 81 children with intraspinal tumors, finding gait and pain disturbances common. Early diagnosis and treatment are crucial for better outcomes in pediatric spinal tumors.
Area of Science:
- Pediatric Oncology
- Neurosurgery
- Clinical Neurology
Background:
- Intraspinal tumors in children are rare but can cause significant morbidity.
- Prompt diagnosis and effective treatment are vital for favorable outcomes.
Purpose of the Study:
- To review the clinical presentation, diagnostic methods, treatment, and outcomes of 81 pediatric patients with intraspinal tumors.
- To emphasize the importance of early intervention for pediatric intraspinal neoplasms.
Main Methods:
- Retrospective analysis of 81 children (<16 years) with intraspinal tumors.
- Evaluation of clinical features, diagnostic imaging (spine radiography, myelography), cerebrospinal fluid analysis, surgical interventions, and follow-up data.
Main Results:
- Gait disturbance, pain, and sphincter issues were prominent symptoms; reflex changes, paralysis, and sensory deficits were frequent findings.
- Diagnostic imaging like myelography was highly effective. Surgical mortality was low (2.5%), with 91.5% of survivors ambulating post-treatment.
- Intramedullary astrocytomas showed a benign course, while metastatic tumors warranted aggressive management.
Conclusions:
- Early diagnosis and treatment significantly improve outcomes for children with intraspinal tumors.
- A tailored treatment approach based on tumor type (e.g., aggressive for metastatic, conservative for benign) is recommended.
- Iatrogenic causes, such as epidermoid tumors, should be considered in pediatric spinal oncology.
Abstract:
The authors have presented 81 children with intraspinal tumors, all less than 16 years of age. The clinical features indicated that gait disturbance, pain, and sphincter disturbance are the most prominent complaints. Reflex changes, paralysis, and sensory impairment are the most frequent physical findings. Cerebrospinal fluid protein was recorded in 47 patients and was abnormal in 34. Spine radiography was abnormal in 58% of the patients. Seventy of the patients had myelography, and it was diagnostic in 67. Surgery was performed on 79 patients, with a 2.5% operative mortality (30 days postsurgery). Of the 49 patients who are alive, 91.5% are able to walk. Mean follow-up period was 8.5 years. The authors document the benign course of the intramedullary astrocytomas and suggest an approach to their treatment. They encourage an aggressive approach to metastatic intraspinal tumors. The latrogenic origin of some epidermoid tumors is noted. The importance of early diagnosis and treatment of the intraspinal tumors in children is emphasized.