J Korean Neurosurg Soc.
1988 Dec;17(6):1359-1368.
Intraspinal Tumors in Children: Clinical Analysis of 24 Cases(1973~1986)
- Affiliations
-
- 1Department of Pediatric Neurosurgery, Seoul National University Children's Hospital, Korea.
- 2Department of Neurosurgery, College of Medicine, Seoul National University, Seoul, Korea.
Abstract
- The authors analyzed 24 cases of intraspinal tumors in children who had been operated upon at the Seoul National University Hospital from 1973 to 1986. The ratio of male of female was 2:1. The pathologic diagnosis revealed neurogenic tumor in 8 cases(33%), metastasis in 3 cases(13%), glioma in 3 cases(13%), lymphoma in 3 cases(33%), metastasis in 3 cases(13%), sarcoma in 3 cases(13%), and tumor of dysembryogenesis in 2 cases(8%). The tumors were located most frequently in the thoracolumbar area(7 cases, 29%) and in the epidural space(12 cases, 50%). Two thirds of the epidural tumors were malignant. The most common initial presentation was motor weakness(9 cases, 38%). Three cases(13%) presented with mass and one case(4%) with flexion deformity. On admission 9 cases(38%) were in the paraparetic stage, 6 cases(25%) in the radiculopathic stage, and 6 cases in the Brown-Sequard syndrome stage. The mean value of the CSF protein was 1, 108 mg%. Plain spine X-rays were abnormal in 17 cases(74%) and the increased interpedicular distance(11 cases, 48%) was the most common radiological abnormality. Myelographic studies were performed in 21 cases and all of them revealed abnormal findings. Total and gross total removal was possible in 13 cases(54%). Radiation therapy was done in 8 cases(33%) and chemotherapy in 5 cases(21%). The surgical result on discharge or at the postoperative one month was recovery in 7 cases(29%), improvement in 10 cases(42%), stationary state in 4 cases(17%), and progression in 3 cases(13%). After 20.8 months of mean follow-up duration in 20 cases(84%), the result was recovery in 13 cases(65%), improvement in 2 cases(10%), stationary state in one case(5%), and progression in 4 cases(20%). As a major complication, there was a spinal deformity in 6 cases(29%) among 21 cases who did not have spinal deformity preoperatively. Three cases(13%) were followed up to their deaths. And the authors discussed the clinical features of the pediatric intraspinal tumors reported in the literature and the results of the present study.
