Abstract
Intramedullary spinal cord tumors (IMSCTs) have specific clinical and pathological features in children. A long clinical course of erratic pains, scoliosis, or both is common. Unlike in adults, astrocytomas occur more frequently in children than ependymomas. A wide spectrum of histological types was observed in our series of 64 children 16-years-old or younger surgically treated for an IMSCT: 40 astrocytomas, 10 ependymomas, 3 gangliogliomas, 7 dysembryoplastic tumors, and 4 miscellaneous tumors. If surgical technique for removal of these tumors is the same as in adults patients and total removal can be achieved in 70 to 90% of the cases depending of the pathology, the approach to the spinal canal must be totally different. The laminotomy and closure must be meticulous, and postoperative immobilization with a brace is necessary. Applying these principles helps avoid postoperative spinal deformities. Long-term outcomes for benign tumors are encouraging. Follow-up without recurrences has been lengthy. The place of adjunct therapies must be defined for chemotherapy (CT), particularly for low-grade gliomas. Radiotherapy is contraindicated in children. New chemotherapeutic agents and new clinical trials are needed to improve the prognosis of malignant tumors.
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