Spinal Cord Tumors, Biology of

The authors discuss the current management of intramedullary spinal cord tumors in children and young adults. Intramedullary spinal cord tumors are rare and comprise only a small percentage of all central nervous system neoplasms. There has been much controversy regarding the optimal management of these tumors, with the majority being histologically benign. The majority of these neoplasms occur in the cervical-thoracic region with pain or a motor deficit as the chief complaint. Surgery on these neoplasms can be performed with safety using surgical adjuncts such as the ultrasonic aspirator, contact laser, and neurophysiological monitoring.A radical resection of these tumors results in a good long-term outcome, because the majority are histologically benign. Adjuvant radiation therapy should only be administered for the high-grade or malignant tumor. Malignant tumors have a dismal outcome and surgery in these patients should be a conservative debulking.