Abstract
Tumours of the spinal column are uncommon in childhood and many present late in the course of their disease. Compared with intradural and intramedullary tumours, the incidence of malignancy is much greater for extradural tumours. The tumour types that affect this compartment are diverse; nonetheless, the differential diagnosis can usually be refined according to patient age and tumour location. The management of vertebral column tumours is dictated by a combination of three factors: the biology of the tumour, the neurological status of the patient, and the presence (or risk) of spinal deformity or instability. Accurate histological diagnosis is pivotal in determining management and prognosis. The potential for treatment related morbidity, particularly following surgery is significant, and thus the role of surgery should be clearly defined through a multidisciplinary approach, such that the timing, extent, and aims of surgery are appropriate and proportionate to the pathology.
This chapter attempts to provide a contemporary overview of the main malignant and benign tumours that may affect the pediatric spinal column, highlighting factors that are particularly pertinent to surgical management.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Acosta FL, Sanai N, Chi JH, Dowd CF, Chin C, Tihan T et al (2008) Comprehensive management of symptomatic and aggressive vertebral hemangiomas. Neurosurg Clin N am 19(1):17–29. https://doi.org/10.1016/j.nec.2007.09.010
Amendola L, Simonetti L, Simoes CE, Bandiera S, De Iure F, Boriani S (2012) Aneurysmal bone cyst of the mobile spine: the therapeutic role of embolization. Eur Spine J: Off Publ Eur Spine Soc Eur Spinal Deformity Soc Eur Section Cervical Spine Res Soc 22(3):533–541. https://doi.org/10.1007/s00586-012-2566-7
Atesok KI, Alman BA, Schemitsch EH, Peyser A, Mankin H (2011) Osteoid osteoma and osteoblastoma. J am Acad Orthop Surg 19(11):678–689
Bacci G, Boriani S, Balladelli A, Barbieri E, Longhi A, Alberghini M et al (2009) Treatment of nonmetastatic Ewing’s sarcoma family tumors of the spine and sacrum: the experience from a single institution. Eur Spine J: Off Publ Eur Spine Soc Eur Spinal Deformity Soc Eur Section Cervical Spine Res Soc 18(8):1091–1095. https://doi.org/10.1007/s00586-009-0921-0
Bertram C, Madert J, Eggers C (2002) Eosinophilic granuloma of the cervical spine. Spine 27(13):1408–1413
Bezdjian A, Alarfaj AA, Varma N, Daniel SJ (2015) Isolated Langerhans cell histiocytosis bone lesion in pediatric patients: systematic review and treatment algorithm. Otolaryngol Head Neck Surg 153(5):751–757. https://doi.org/10.1177/0194599815598969
Bloomer CW, Ackerman A, Bhatia RG (2006) Imaging for spine tumors and new applications. Top Magn Reson Imaging TMRI 17(2):69–87. https://doi.org/10.1097/RMR.0b013e31802bb38f
Boriani S, Weinstein JN, Biagini R (1997) Primary bone tumors of the spine. Terminology and surgical staging. Spine 22(9):1036–1044
Burch S, Hu S, Berven S (2008) Aneurysmal bone cysts of the spine. Neurosurg Clin N Am 19(1):41–47. https://doi.org/10.1016/j.nec.2007.09.005
Chi JH, Sciubba DM, Rhines LD, Gokaslan ZL (2008) Surgery for primary vertebral tumors: en bloc versus intralesional resection. Neurosurg Clin N Am 19(1):111–117. https://doi.org/10.1016/j.nec.2007.10.004
Choi D, Melcher R, Harms J, Crockard A (2010) Outcome of 132 operations in 97 patients with chordomas of the craniocervical junction and upper cervical spine. Neurosurgery 66(1):59–65; discussion 65. https://doi.org/10.1227/01.NEU.0000362000.35742.3D
Cohn SL, Pearson ADJ, London WB, Monclair T, Ambros PF, Brodeur GM et al (2009) The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force report. J Clin Oncol Off J am Soc Clin Oncol 27(2):289–297. https://doi.org/10.1200/JCO.2008.16.6785
Cottalorda J, Kohler R, de Gauzy JS, Chotel F, Mazda K, Lefort G et al (2004) Epidemiology of aneurysmal bone cyst in children: a multicenter study and literature review. J Pediatr Orthop B 13(6):389–394
De Bernardi B, Balwierz W, Bejent J, Cohn SL, Garrè ML, Iehara T et al (2005) Epidural compression in neuroblastoma: diagnostic and therapeutic aspects. Cancer Lett 228(1–2):283–299. https://doi.org/10.1016/j.canlet.2005.01.053
De Bernardi B, Quaglietta L, Haupt R, Castellano A, Tirtei E, Luksch R et al (2014) Neuroblastoma with symptomatic epidural compression in the infant: the AIEOP experience. Pediatr Blood Cancer 61(8):1369–1375. https://doi.org/10.1002/pbc.25028
Dubois J, Chigot V, Grimard G, Isler M, Garel L (2003) Sclerotherapy in aneurysmal bone cysts in children: a review of 17 cases. Pediatr Radiol 33(6):365–372
Favara BE, Feller AC, Pauli M, Jaffe ES, Weiss LM, Arico M et al (1997) Contemporary classification of histiocytic disorders. The WHO Committee on histiocytic/reticulum cell proliferations. Reclassification Working Group of the Histiocyte Society. Med Pediatr Oncol 29(3):157–166
Garg S, Dormans JP (2005) Tumors and tumor-like conditions of the spine in children. J am Acad Orthop Surg 13(6):372–381
Garg S, Mehta S, Dormans JP (2004) Langerhans cell histiocytosis of the spine in children. Long-term follow-up. J Bone Joint Surg Am Vol 86-A(8):1740–1750
Garg S, Mehta S, Dormans JP (2005) Modern surgical treatment of primary aneurysmal bone cyst of the spine in children and adolescents. J Pediatr Orthop 25(3):387–392
Grattan-Smith PJ, Ryan MM, Procopis PG (2000) Persistent or severe back pain and stiffness are ominous symptoms requiring prompt attention. J Paediatr Child Health 36(3):208–212
Griessenauer CJ, Salem M, Hendrix P, Foreman PM, Ogilvy CS, Thomas AJ (2016) Preoperative embolization of spinal tumors: a systematic review and meta-analysis. World Neurosurg 87:362–371. https://doi.org/10.1016/j.wneu.2015.11.064
Gunes D, Uysal KM, Cetinkaya H, Tekin HG, Yuceer N, Sarialioglu F, Olgun N (2009) Paravertebral malignant tumors of childhood: analysis of 28 pediatric patients. Childs Nerv Syst ChNS Off J Int Soc Pediatr Neurosurg 25(1):63–69. https://doi.org/10.1007/s00381-008-0717-2
Guzey FK, Emel E, Aycan A, Bas NS, Seyithanoglu MH, Ozkan N, Karabulut C (2008) Pediatric vertebral and spinal epidural tumors: a retrospective review of twelve cases. Pediatr Neurosurg 44(1):14–21. https://doi.org/10.1159/000110657
Harrop JS, Schmidt MH, Boriani S, Shaffrey CI (2009) Aggressive “benign” primary spine neoplasms: osteoblastoma, aneurysmal bone cyst, and giant cell tumor. Spine 34(22 Suppl):S39–S47. https://doi.org/10.1097/BRS.0b013e3181ba0024
Hoover M, Bowman LC, Crawford SE, Stack C, Donaldson JS, Grayhack JJ et al (1999) Long-term outcome of patients with intraspinal neuroblastoma. Med Pediatr Oncol 32(5):353–359
Hug EB, Slater JD (2000) Proton radiation therapy for chordomas and chondrosarcomas of the skull base. Neurosurg Clin N am 11(4):627–638
Hug EB, Sweeney RA, Nurre PM, Holloway KC, Slater JD, Munzenrider JE (2002) Proton radiotherapy in management of pediatric base of skull tumors. Int J Radiat Oncol Biol Phys 52(4):1017–1024
Joaquim AF, Cheng I, Patel AA (2012) Postoperative spinal deformity after treatment of intracanal spine lesions. Spine J 12(11):1067–1074. https://doi.org/10.1016/j.spinee.2012.09.054
Katzenstein HM, Kent PM, London WB, Cohn SL (2001) Treatment and outcome of 83 children with intraspinal neuroblastoma: the Pediatric Oncology Group experience. J Clin Oncol Off J am Soc Clin Oncol 19(4):1047–1055
Kim HJ, McLawhorn AS, Goldstein MJ, Boland PJ (2012) Malignant osseous tumors of the pediatric spine. J am Acad Orthop Surg 20(10):646–656. https://doi.org/10.5435/JAAOS-20-10-646
Leithner A, Windhager R, Lang S, Haas OA, Kainberger F, Kotz R (1999) Aneurysmal bone cyst. A population based epidemiologic study and literature review. Clin Orthop Relat res 363:176–179
Mattei TA, Teles AR, Mendel E (2015) Modern surgical techniques for management of soft tissue sarcomas involving the spine: outcomes and complications. J Surg Oncol 111(5):580–586. https://doi.org/10.1002/jso.23805
Mayfield JK, Riseborough EJ, Jaffe N, Nehme ME (1981) Spinal deformity in children treated for neuroblastoma. J Bone Joint Surg Am Vol 63(2):183–193
McGirt MJ, Garcés Ambrossi GL, Parker SL, Sciubba DM, Bydon A, Wolinksy J-P et al (2010) Short-term progressive spinal deformity following laminoplasty versus laminectomy for resection of intradural spinal tumors: analysis of 238 patients. Neurosurgery 66(5):1005–1012. https://doi.org/10.1227/01.NEU.0000367721.73220.C9
Novais EN, Rose PS, Yaszemski MJ, Sim FH (2011) Aneurysmal bone cyst of the cervical spine in children. J Bone Joint Surg am 93(16):1534–1543. https://doi.org/10.2106/JBJS.J.01430
Peng X-S, Pan T, Chen L-Y, Huang G, Wang J (2009) Langerhans’ cell histiocytosis of the spine in children with soft tissue extension and chemotherapy. Int Orthop 33(3):731–736. https://doi.org/10.1007/s00264-008-0529-8
Sadashiva N, Rajalakshmi P, Mahadevan A, Vazhayil V, Rao KN, Somanna S (2016) Surgical treatment of Langerhans cell histiocytosis of cervical spine: case report and review of literature. Childs Nerv Syst. https://doi.org/10.1007/s00381-015-2989-7
Sandberg DI, Bilsky MH, Kushner BH, Souweidane MM, Kramer K, Laquaglia MP et al (2003) Treatment of spinal involvement in neuroblastoma patients. Pediatr Neurosurg 39(6):291–298. https://doi.org/10.1159/000075256
Sciubba DM, Hsieh P, McLoughlin GS, Jallo GI (2008) Pediatric tumors involving the spinal column. Neurosurg Clin N am 19(1):81–92. https://doi.org/10.1016/j.nec.2007.09.008
Sebaaly A, Ghostine B, Kreichati G, Mallet JF, Glorion C, Moussa R et al (2015) Aneurysmal bone cyst of the cervical spine in children: a review and a focus on available treatment options. J Pediatr Orthop 35(7):693–702. https://doi.org/10.1097/BPO.0000000000000365
Sewell MD, Tan K-A, Quraishi NA, Preda C, Varga PP, Williams R (2015) Systematic review of en bloc resection in the management of Ewing’s Sarcoma of the mobile spine with respect to local control and disease-free survival. Medicine (Baltimore) 94(27):e1019–e1019. https://doi.org/10.1097/MD.0000000000001019
Sinelnikov A, Kale H (2014) Osteochondromas of the spine. Clin Radiol 69(12):e584–e590. https://doi.org/10.1016/j.crad.2014.08.017
Singh PK, Chandra PS, Vaghani G, Savarkar DP, Garg K, Kumar R et al (2015) Management of pediatric single-level vertebral hemangiomas presenting with myelopathy by three-pronged approach (ethanol embolization, laminectomy, and instrumentation): a single-institute experience. Childs Nerv Syst 32(2):307–314. https://doi.org/10.1007/s00381-015-2941-x
Sobti A, Agrawal P, Agarwala S, Agarwal M (2016) Giant cell tumor of bone - an overview. Arch Bone Joint Surg 4(1):2–9
Tauziède-Espariat A, Bresson D, Polivka M, Bouazza S, Labrousse F, Aronica E et al (2016) Prognostic and therapeutic markers in chordomas: a study of 287 tumors. J Neuropathol Exp Neurol. https://doi.org/10.1093/jnen/nlv010
Uzunaslan D, Saygin C, Gungor S, Hasiloglu Z, Ozdemir N, Celkan T (2013) Novel use of propranolol for management of pain in children with vertebral hemangioma: report of two cases. Childs Nerv Syst ChNS Off J Int Soc Pediatr Neurosurg 29(5):855–860. https://doi.org/10.1007/s00381-012-2012-5
Vanderschueren GM, Obermann WR, Dijkstra SPD, Taminiau AHM, Bloem JL, van Erkel AR (2009) Radiofrequency ablation of spinal osteoid osteoma: clinical outcome. Spine 34(9):901–904. https://doi.org/10.1097/BRS.0b013e3181995d39
Yamazaki T, McLoughlin GS, Patel S, Rhines LD, Fourney DR (2009) Feasibility and safety of en bloc resection for primary spine tumors: a systematic review by the Spine Oncology Study Group. Spine 34(22 Suppl):S31–S38. https://doi.org/10.1097/BRS.0b013e3181b8b796
Zenonos G, Jamil O, Governale LS, Jernigan S, Hedequist D, Proctor MR (2012) Surgical treatment for primary spinal aneurysmal bone cysts: experience from Children’s Hospital Boston. J Neurosurg Pediatr 9(3):305–315. https://doi.org/10.3171/2011.12.PEDS11253
Zileli M, Cagli S, Basdemir G, Ersahin Y (2003) Osteoid osteomas and osteoblastomas of the spine. Neurosurg Focus 15(5):E5
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this entry
Cite this entry
Thompson, D.N.P. (2020). Vertebral Tumours. In: Di Rocco, C., Pang, D., Rutka, J. (eds) Textbook of Pediatric Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-72168-2_131
Download citation
DOI: https://doi.org/10.1007/978-3-319-72168-2_131
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-72167-5
Online ISBN: 978-3-319-72168-2
eBook Packages: MedicineReference Module Medicine