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Treatment of spinal cord tumors in children
1Department of Pediatric Oncology, University Hospital, Prague, Czech Republic.
Insights
Surgical removal of pediatric intramedullary tumors offers the best prognosis. However, spinal deformities following laminectomy and irradiation necessitate orthopedic supervision for long-term management.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Oncology
- Spinal Cord Tumors
Background:
- Retrospective review of 9 pediatric patients (<17 years) with intramedullary tumors (1989-1995).
- Tumor types included astrocytomas, ependymoma, PNET, and choroid plexus papilloma.
- Presenting symptoms ranged from back pain to severe neurological deficits.
Purpose of the Study:
- To evaluate the outcomes of pediatric intramedullary tumors.
- To identify long-term complications associated with treatment.
Main Methods:
- Surgical intervention: subtotal extirpation in 7 patients, biopsy in 2.
- Postoperative treatment: radiation therapy (RT) in 8 patients due to low-grade tumors (I or II).
Main Results:
- Seven of nine (77.8%) patients were alive at follow-up (median 3 years 4 months).
- Two patients (22.2%) died due to recurrent tumor.
- No mention of specific surgical or radiation techniques.
Conclusions:
- Surgical removal is crucial for controlling intraspinal tumors in children.
- Spinal deformities post-laminectomy and irradiation are significant long-term issues.
- Mandatory orthopedic supervision is required to prevent and manage these deformities.
Background:
A retrospective review was carried out of nine children under 17 years of age with a diagnosis of intramedullary tumor seen during the period 1989-1995. Six had astrocytomas; one each had an ependymoma, a PNET, and a choroid plexus papilloma. Five patients had back pain, 3 others had mild pareses and the ninth had incapacitating defects. Seven of the 9 were treated by subtotal extirpation of the lesion, and biopsy alone was performed in the other two. All tumors were low grade (grade I or II) and therefore radiation therapy (RT) was performed as the only postoperative treatment in 8 of the 9 children.
Results:
In February 1996, seven (77.8%) children were alive and two (22.2%) died of recurrent tumor (7 months and 5 years after diagnosis, respectively). Median follow-up was 3 years 4 months (range: 1 year 6 months to 7 years 3 months).
Conclusion:
Surgical removal of intraspinal tumors provides the best hope of control, but spinal column deformity after laminectomy and irradiation is a serious long-term problem in children. Orthopedic supervision for the prevention of these deformities; e.g., by external immobilization, is mandatory.