TREATMENT OF SPINAL-CORD TUMORS IN CHILDREN

Background. A retrospective review was carried out of nine children un der 17 years of age with a diagnosis of intramedullary tumor seen duri ng the period 1989-1995. Six had astrocytomas; one each had an ependym oma, a PNET, and a choroid plexus papilloma. Five patients had back pa in, 3 others had mild pareses and the ninth had incapacitating defects . Seven of the 9 were treated by subtotal extirpation of the lesion, a nd biopsy alone was performed in the other two. All tumors were low gr ade (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%) di ed of recurrent tumor (7 months and 5 years after diagnosis, respectiv ely). 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. (C) 1997 Wiley-Liss, Inc.