Candidates

Children

Whenever the diagnosis of an intramedullary spinal cord tumor is made in a child surgery should be considered as the first choice for treatment. This will establish a tissue diagnosis. The chances of controlling tumor growth in the long term are very good once a near-complete resection is achieved. The chances of recovering from the operation with normal or near normal neurological function are optimal when the operation is performed before the tumor itself has caused significant neurological dysfunction.

Occasionally, these tumors manifest only with a curvature of the spine without any neurological dysfunction. Even in these children, it is essential that the surgery be carried out prior to additional symptoms evolving.

It cannot be overemphasized that it is essential to operate on these tumors as early as possible. Once weakness or neurological impairment is established before surgery it does not significantly improve afterward. In other words, it is much easier to preserve the function that is present than to recover lost function! Of course this is exactly the situation that causes the greatest anxiety for a family and a patient, to accept the surgical risk in a situation that does not feel threatening. From the surgeon's perspective this means operating on a patient when his or her symptoms are minimal. Key in managing this condition is the appreciation that performing surgery early, before irreversible dysfunction sets in, is essential.

Adults

As with children, it is critical that surgery be performed as early as possible in adults. Function once lost is rarely recovered with tumor resection. In the adult population more than the pediatric, the purpose of surgery is to arrest neurological progression. It is critical that surgery be carried out prior to the development of significant neurological disability.

Cheryl Fried, RN