PEDIATRIC INTRAMEDULLARY SPINAL-CORD TUMORS - IS SURGERY ALONE ENOUGH

Pediatric intramedullary spinal cord tumors occur infrequently with li mited data on treatment strategies and outcome. Over an 11-year period , 44 patients with such tumors who were primarily managed by radical s urgery were retrospectively reviewed. The majority of tumors (42/44, 9 5%) were in the cervical or thoracic spine and were histologically low grade. Gross total resection was achieved in 73% (32/44). At a median follow-up of 45 months, 11% (5/44) had severe weakness (modified McCo rmick scale IV-V), 66% (29/44) had mild-moderate deficits (I-III), and 16% (7/44) had sphincter dysfunction. Tumor recurrence rate was 18% ( 8/44) after a mean period of 54 months. Age, number of involved spinal cord segments and extent of surgical resection did not significantly impact on tumor recurrence rates (p = 0.28, 0.44 and 0.13, respectivel y). The only significant prognostic factor was histological type; mixe d or higher grade tumors having a higher recurrence rate (p = 0.04). R adical surgery for intraspinal tumors can achieve long tumor-free surv ival without requiring adjuvant therapy.