Intramedullary spinal cord tumors (IMSCTs) of the pediatric population are
rare and comprise thirty-five percent of intraspinal neoplasms. Low-grade a
strocytomas predominate; ependymomas increase in frequency with ascending a
ge and become the most frequent IMSCT in adults. Gangliogliomas are very ra
re in adults but comprise nearly thirty percent of tumors in children under
three years of age. The cervical spine is the region of the spine most aff
ected. Pain is the most common presenting symptom with weakness, gait deter
ioration, torticollis also frequently reported. Hydrocephalus occurs with g
reater frequency than in adult patients and often requires a shunt. Motor a
nd sensory evoked potential monitoring is routinely utilized. Osteoplastic
laminotomy is performed to forestall the development of progressive spinal
deformity. Gross total resection is feasible in most ependymomas and result
s in surgical cure. Astrocytomas are infiltrating neoplasms and gross total
resection is occasionally possible only in the pediatric population. Howev
er, the role of radical resection of low-grade fibrillary astrocytomas of t
he spinal cord in children has not been definitively demonstrated in the li
terature. Outcome for low-grade astrocytomas is better in children than adu
lts, but not as favorable as that for ependymomas. Malignant tumors have di
smal outcomes and surgery in these patients serves only to provide a diagno
sis.