Pediatric vertebral and spinal cord tumors: A retrospective study of musculoskeletal aspects of presentation, treatment, and complications

Fifty-two pediatric patients with documented vertebral and spinal cord tumo rs were reviewed to evaluate the musculoskeletal manifestations of presenta tion, treatment, and management of complications. Diagnoses included 16 mal ignant and 36 nonmalignant vertebral and spinal cord tumors. Mean age at di agnosis was 8 years 1 month, and the male-to-female ratio was 1.7:1. Overal l, there was an average delay in diagnosis of 12 months for this group of p atients. Mean clinical followup was 5 years. The two most common reasons for presentation were pain (67%) and spinal def ormity (46%). Initial plain radiographs were positive in 82% of patients. P ostlaminectomy spinal deformity occurred at a rate of 45% in patients under going laminectomies and 60% of those with deformity required spinal fusion. Overall, 67% of the 52 patients underwent spinal fusion, with a 9% asympto matic pseudarthrosis rate. Complications were common, with 1.9 complication s per patient; 59% of complications required surgical management. There wer e no perioperative deaths. At follow-up, 19% of patients had neurologic def icits ranging from neurogenic bladder to lower extremity weakness and diffi culty walking to quadriplegic. Eighty-six percent of patients were ambulati ng without difficulty at follow-up. The survival rate was 94% and the local recurrence rate was 27% at most recent follow-up.