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School of Medicine
Pediatric Spinal Cord Tumors
What is a spinal cord tumor?
Abnormal tissue growths within or next to the spinal cord, called spinal cord tumors, are very rare. Whether they are malignant (cancerous) or benign (non-cancerous), they can cause serious neurological deficits because as they grow the spinal cord becomes compromised.
Prompt diagnosis and treatment are necessary to prevent these deficits from becoming permanent. With recent advances in treatments options, surgical instruments and surgical techniques, this type of tumor can be managed well and successfully treated.
Symptoms of a spinal cord tumor
Because spinal cord tumors grow slowly over time, symptoms tend to develop over months. Symptoms also vary from patient to patient, and can include the following:
- Chronic neck or back pain – This is the most common symptom. The pain can either be very localized or radiating. Some children do not show any symptoms until they experience a minor injury, like a sports accident. If a child complains of chronic back pain that does not resolve itself or worsens, he/she should be examined and evaluated quickly.
- Vague or nonspecific complaints — Some infants and young children can complain of seemingly unrelated pain, like abdominal pain. These children often undergo extensive evaluations of the unrelated area before a spinal cord tumor is ultimately identified.
- Specific neurological complaints — As the tumors expand and create compression within the spinal cord, normal neurological function is impacted. These symptoms are sometimes confused with “growth pains.” These specific symptoms can include:
- Decreased motor skills
- Muscle weakness, which can progress to paralysis without prompt intervention
- Sensory loss or numbness
- Pure sensory dysfunction, although this is very rare
- Loss of bowel or bladder control
- Spinal deformity — Scoliosis occurs in up to one third of children with spinal cord tumors
How is a spinal cord tumor diagnosed?
Symptoms can be difficult to identify in children so regular check-ups with a pediatrician are extremely important. To ensure a timely diagnosis, a child’s pediatrician should be consulted as soon as any of the symptoms or neurological deficits outlined above display themselves. With proper diagnosis and treatment, these tumors can be managed and successfully treated.
A diagnostic evaluation begins with a thorough medical history and physical examination. A detailed neurological assessment is also performed. Several diagnostic tests will be run, and can include:
- Cerebrospinal fluid analysis — to look for tumor cells
- Radiological imaging studies — to identify the location and appearance of the tumor.
- MRI (magnetic resonance imaging) is the most helpful diagnostic tool. Using intravenous contrast agents, a physician can view the tumor’s structure, exact location and size in relation to the spinal cord.
- Computed tomography (CT) scans help the physician look for tumor lesions in other areas of the body. If the spine tumor is believed to arise from outside the spinal cord, this is an important tool.
- Biopsy — from the actual tumor in order to provide a precise classification.
Learn more about how pediatric spinal cord tumors are diagnosed at the Johns Hopkins Pediatric Brain & Spinal Cord Tumor Center.
Types of spinal cord tumors
Spinal cord tumors are classified based on their anatomical position within the spine as follows:
- Intramedullary tumors — These are the least common spinal tumors. They rise within the actual spinal cord. Many are classified as gliomas, meaning they derive from the cells that nourish and support the spinal cord.
- Intradural tumors — These tumors arise inside the covering of the spinal cord, the dura, but outside the spinal cord substance. Typically these tumors are benign.
- Extradural tumors — These appear outside the membranes that envelop the spinal cord, and are either:
- Primary bone tumors, which originate from the spinal tissue, or
- Metastatic tumors, which originate in another part of the body.
Spinal cord tumors are also classified by cell type. A pathologist will examine the cells microscopically and assign a grade to indicate how quickly the tumor is growing or dividing. A low number indicates slow growth while a high number indicates an aggressive, faster-growing tumor.
Learn more about types of spinal cord tumors in children at the Johns Hopkins Pediatric Brain & Spinal Cord Tumor Center.
Treatment for spinal cord tumors in children
The Johns Hopkins involves multiple specialties in reviewing the cases of children with spinal cord tumors. Neurosurgeons, neurologists, oncologists and rehabilitation therapists, among others, join together to develop the treatment plan. The team will decide if surgery is the best option. To avoid compromising a child’s neurological function, most spinal cord tumors are removed surgically. Even if they are benign, there is inevitable spinal pressure created by tumor growth.
Learn more about treatment for spinal cord tumors in children at the Johns Hopkins Pediatric Brain & Spinal Cord Tumor Center.
The recovery process is different for each patient. Children who received prompt diagnosis and treatment do well after surgery. Some may experience some temporary neurological deficits, such as muscle weakness. In most cases, this goes away shortly after surgery, unless there was substantial permanent damage before the child was diagnosed. Physical therapy will help improve strength, function and speed of recovery.
Most children are able to go home shortly after surgery, requiring only pain medications while the surgical site heals. They should be encouraged to assume their regular daily activities, like school, social events and play. Physical activities should be encouraged as tolerated. Other specific treatment recommendations made by the neurosurgeon should be followed carefully.
Regular post-operative follow-up visits with the child’s neurosurgeon are also important. This allows the neurological function, tumor recurrence and side-effects from chemo-radiation therapy to be monitored carefully.
To request a consultation or make an appointment, please contact Johns Hopkins Pediatric Neurosurgery at 410-955-7337.
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