[Clinical study of intraspinal neoplasms in children]

The authors report a series of 10 children under 15 years of age with primary intraspinal neoplasm who underwent surgical resection from 1981 to 1994. The tumors consisted of 4 intramedullary tumors (myxopapillary ependymoma, pilocytic astrocytoma, subpial liporna, cavernous angioma), 2 intradural extramedullary tumors (2 neurinomas), and 4 extradural tumors (ganglioneuroma, chordoma, osteochondroma, rhabdomyosarcoma). The initial symptoms in these patients were gait disturbance (50%), weakness of lower extremities (50%), pain (40%), weakness of upper extremities (10%), and tetraparesis (10%). The neurological findings on admission in these patients revealed motor paresis (90%), sensory disturbance (60%), abnormality of deep tendon reflex (60%), pathological reflex (30%), neurogenic bladder (30%), and Lasegue's sign (10%). All patients were treated surgically; laminectoy was performed in 8 patients, laminoplasty in one patient, and transoral approach in one patient. Five patients (50%) underwent a grossly total resection, 3 (30%) had a subtotal resection, and 2 (20%) had a partial resection. Mean follow-up period was 5.6 years. One (10%) patient died due to recurrence and dissemination of the tumor at eight months after surgery in a case of rhabdomyosarcoma. 9 (90%) have had no recurrent tumor and have improved neurologically. In 4 patients (40%) spinal deformity developed, and 2 patients required operative treatment for the spinal deformity. We emphasized the advantage of laminoplasty to prevent postoperative spinal deformity in children.