Cervical tumors of infancy and childhood

Primary spinal cord tumors of childhood and adolescence affect the cervical segment with the same frequency as other segments. Apart from epidermoids and dermoids, all oncotypes are represented. Astrocytomas and lipomas seem to prefer these metameres. Differential diagnosis has been habitually problematic for cord compression in children. Cervical tumors are too often mistaken for congenital torticollis, birth palsy, cerebral palsy and posterior fossa tumors. Of the various diagnostic aids, CT is of great importance and in selected cases so is vertebral angiography. An aggressive surgical strategy is favored with radicality as the aim. However, the manipulation of solid intramedullary gliomas at cervical level carries the risk of immediate and severe complications (hyperthermia, respiratory failure, sleeping apnea) and the long term results are not satisfactory. There is less risk of postoperative spinal deformity at cervical than at lower levels.