A RARE CAUSE OF LOWER LIMB PAIN - INTRAMEDULLARY DERMOID - A CASE REPORT

Dermoid cyst is a benign tumor. It accounts for only 1-2% of intra spinal tumors. -It is most common in children less than 10yrs of age accounting for 10-17%. -Only 1% of dermoid cyst occurs intramedullary. The usual sites are lumbosacral spine(60%), thoracic spine(10%), and cervical spine(10%). -The common presentation is with pain in lower limbs, back pain, balance problems, numbness and weakness, seizures, headaches. Here we are presenting 4 year male child.

Microscopic resection of lumbar intraspinal tumor through keyhole approach: A clinical study of 54 cases / 北京大学学报(医学版)

OBJECTIVE@#To explore the feasibility and key technology of microscopic resection of lumbar intraspinal tumor through microchannel keyhole approach.@*METHODS@#The clinical features, imaging characteristics and surgical methods of 54 cases of lumbar intraspinal tumor which were microscopically operated by microchannel from February 2017 to September 2019 were reviewed and analyzed. There were 8 cases of extradural tumor, 3 cases of extra-and intradural tumor and 43 cases of subdural extramedullary tumor (including 3 cases of ventral spinal tumor). The tumors were 0.5-3.0 cm in diameter. The clinical symptoms included 49 cases of pain in the corresponding innervation area, 5 cases of sensory disturbance (numbness) at or below the tumor segment, 7 cases of limb weakness and 2 cases of urination and defecation dysfunction.@*RESULTS@#In the study, 37 tumors were resected through hemilaminectomy, 14 tumors were resected through interlaminar fenestration, 3 tumors were resected through hemilaminectomy or interlaminar fenestration combined with facetectomy of medial 1/4 facet. All of the 54 tumors were totally resected. The operation time was 75-135 min, with an average of 93.3 min. The postoperative hospital stay was 4-7 days, with an average of 5.7 days. Postoperative pathology included 34 cases of schwannoma, 4 cases of meningioma, 9 cases of ependymoma, 1 case of enterogenous cyst, 5 cases of teratoma/epidermoid/dermoid cyst, and 1 case of paraganglioma. No infection or cerebrospinal fluid leakage was found after operation. No neurological dysfunction occurred except 1 case of urination dysfunction and 4 cases of limb numbness. The follow-up period ranged from 3 to 33 months with an average of 14.4 months. Five patients with new onset symptoms returned to normal. The pain symptoms of 49 patients were completely relieved; 4 of 5 patients with hypoesthesia recovered completely, the other 1 patient had residual mild hypoesthesia; 7 patients with limb weakness, and 2 patients with urination and defecation dysfunction recovered to normal. No spinal instability or deformity was found, and no recurrence or residual tumors were found. According to McCormick classification, they were of all grade Ⅰ.@*CONCLUSION@#The lumbar intraspinal extramedullary tumors within two segments (including the ventral spinal tumors) can be totally resected at stage Ⅰ through microchannel keyhole approach with appropriate selection of the cases. Microchannel technique is beneficial to preserve the normal structure and muscle attachment of lumbar spine, and to maintain the integrity and stability of lumbar spine.

Clinical Analysis of Primary Thoracic and Lumbar Intraspinal Tumors Misdiagnosed as Lumbar Intervertebral Disc Herniation: Report of 19 Cases

Introduction: Intraspinal tumors were primary and secondarytumors that occurred in the spinal cord, nerve roots, meningesand the tissue of the wall of vertebral canal. Study aimedto analyze the misdiagnosis causes of intraspinal tumorsmisdiagnosed as lumbar intervertebral disc herniation, and toreduce the rate of clinical misdiagnosis.Material and Methods: Clinical data of 19 patients withintraspinal tumors misdiagnosed as lumbar intervertebral discherniation were retrospectively analyzed, and the respectivecharacteristics, essentials for diagnosis and differentialdiagnosis of the two different kinds of diseases weresummarized. The misdiagnosis causes were analyzed, and theprevention measures were put forward.Results: All the misdiagnosed patients’ data on MRI werecollected, and then they received operative treatment.Histological diagnosis results showed that there were 13cases of schwannomas, 3 cases of meningiomas, 2 casesof ependymomas, and 1 case of angiomyolipoma. In 1~36months’ follow-up, pain of all the patients was alleviated.Eighteen patients were healed, and only one patient still feltnumbness at left hip and left leg. No patient reoccurred ordied.Conclusion: Though there were similarities in early clinicalmanifestations between intraspinal tumors and lumbarintervertebral disc herniation, these two different kinds ofdiseases can be identified by collecting the case historydetailedly, performing physical examination carefully, andchoosing the imaging examination appropriately to avoidmisdiagnosis.

Treatment of benign tumors in thoracic spinal canal by modified replanting posterior ligament complex applying piezoelectric osteotomy / 中国修复重建外科杂志

Objective: To investigate the feasibility and effectiveness of modified replanting posterior ligament complex (PLC) applying piezoelectric osteotomy in the treatment of primary benign tumors in thoracic spinal canal. Methods: The clinical data of 38 patients with primary benign tumors in thoracic spinal canal between March 2014 and March 2016 were retrospectively analyzed. There were 16 males and 22 females, aged from 21 to 72 years (mean, 47.1 years). The disease duration ranged from 6 to 57 months (mean, 32.6 months). Pathological examination showed 24 cases of schwannoma, 6 cases of meningioma, 4 cases of ependymoma, 2 cases of lipoma, and 2 cases of dermoid cyst. The lesions located in 18 cases of single segment, 15 cases of double segments, and 5 cases of three segments. The length of the tumors ranged from 0.7 to 6.5 cm. There were boundaries between the tumors and the spinal cord, cauda equina, and nerve roots. The preoperative Japanese Orthopaedic Association (JOA) score was 12.2±2.3 and the thoracic Cobb angle was (11.7±2.7)°. Modified PLC replantation and microsurgical resection were performed with piezoelectric osteotomy. Continuity of uniside supraspinal and interspinous ligaments were preserved during the operation. The PLC was exposed laterally. After removing the tumors under the microscope, the pedicled PLC was replanted in situ and fixed with bilateral micro-reconstruction titanium plate. X-ray film, CT, and MRI examinations were performed to observe spinal stability, spinal canal plasty, and tumor resection after operation. The effectiveness was evaluated by JOA score. Results: The operation time was 56-142 minutes (mean, 77.1 minutes). The intraoperative blood loss was 110-370 mL (mean, 217.2 mL). The tumors were removed completely and the incisions healed well. Three cases complicated with cerebrospinal fluid leakage, and there was no complications such as spinal cord injury and infection. All the 38 patients were followed up 24-28 months (mean, 27.2 months). There was no internal fixation loosening, malposition, or other related complications. At last follow-up, X-ray films showed no sign of kyphosis and instability. CT showed no displacement of vertebral lamina and reduction of secondary spinal canal volume, and vertebral lamina healed well. MRI showed no recurrence of tumors. At last follow-up, the thoracic Cobb angle was (12.3±4.1)°, showing no significant difference when compared with preoperative value ( t=0.753, P=0.456). JOA score increased to 23.7±3.8, showing significant difference when compared with preoperative value ( t=15.960, P=0.000). Among them, 14 cases were excellent, 18 were good, 6 were fair, and the excellent and good rate was 84.2%. Conclusion: Modified replanting PLC applying piezoelectric osteotomy and micro-reconstruction with titanium plate for the primary benign tumors in thoracic spinal canal can reconstruct the anatomy of the spinal canal, enable patients to recover daily activities quickly. It is an effective and safe treatment.

Efficacy of laminoplasty and bone graft in the treatment of multilevel intraspinal tumor / 国际外科学杂志

Objective To investigate the clinical effect of laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors.Methods Retrospectively review the clinical data of 35 patients suffering multiple segmental intraspinal tumors,who underwent the laminoplasty with bone grafting for intraspinal tumor resection in Department of Neurosurgery,Clinical Medical College of Yangzhou University,from June 2013 to May 2016.Observation indicators:(1) surgical and postoperative recovery situations,including tumor resection,number of lamina reset,tumor pathological results,clinical efficacy evaluation,complications,etc;(2) follow-up situations,including spinal stability evaluation,rate of bone graft fusion,tumor recurrence.Follow-up using outpatient examination and telephone interview was performed by the end of December 2017.Results (1) Surgical and postoperative recovery situations:of the 35 patients,31 achieved total tumor resection,3 subtotal tumor resection and 1 partial tumor resection.There were no spinal dura mater injuries when laminectomy was performed,and 84 laminae were repositioned and implanted.The neurological function of the spinal cord was evaluated based on McCormick scoring system:32 cases were improved and 3 cases were controlled.Incision healing was bad in 2 patients,and cerebrospinal fluid leakage occurred in 1 case,which all recovered after treatment.(2) Follow-up situations:all the 35 patients were followed up for 8 to 36 months,with a median time of 14.2 months.Imaging examination more than 6 months after operation:no spinal instability was found in standing spine X-ray examination;CT scan showed a total of 142 sides in the 84 vertebral plates (168 sides) had achieved bone fusion,the fusion rate was 84.5％,and no titanium nail removal and connecting piece shift was found;MRI showed no tumor recurrence in all patients.Conclusion Use of the laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors can achieve good clinical efficacy,high fusion rate for resected laminae and satisfactory spinal stability.

Retrospective analysis of surgical treatment and postoperative follow-up study of adult primary intraspinal tumors / 中国肿瘤临床

Objective:To evaluate the diagnosis, surgical treatment, and neurological function recovery after surgery of patients with intraspinal tumors. Methods:The clinical data of 69 patients who suffered from intraspinal tumors and underwent surgery from Janu-ary 2008 to December 2012 were retrospectively analyzed. Neuroimaging and ASIA scoring were performed to examine the pathologi-cal characteristics of tumors and the neurological function of these patients before and after treatment. The major factors affecting prognosis were also probed, and the average follow-up period was 12.2 months. Results:Of the total cases, 62.3%showed intradural extramedullary intraspinal tumors located in the thoracic vertebra. Neurilemoma (Schwannoma) and meningioma were the most com-mon pathological types (53.5%). Posterior approaches with hemi-and complete-laminectomy were conducted to expose the intraspi-nal tumors, and the separation and removal of the tumors located at the cervical and thoracic levels were aided with surgical microsco-py. The main clinical symptoms, including back pain, radicular neuralgia, sensory disturbance, and motor dysfunction, were significant-ly improved after surgery, and this observation was supported by the follow-up ASIA scores before and after treatment. Of the in-volved cases, 91%were successfully treated, and their tumors were totally resected. Conclusion:Total or subtotal intraspinal tumor re-section enhanced with surgical microscopy could achieve satisfactory clinical results through posterior hemi-or complete-laminectomy.

Comparison of the modified expanding suspended laminoplasty and posterior pedicle screw fixation for lumbar intraspinal tumors / 西安交通大学学报(医学版)

Objective To compare the modified expanding suspended laminoplasty and posterior pedicle screw fixation applied in lumbar intraspinal tumors and evaluate operation,complications,postoperative neurofunctional improvement and lumbar lumbar stability in the two groups.Methods We made a retrospective analysis of the clinical data of 1 14 cases of lumbar intraspinal tumors, including 66 cases of modified expanding suspended laminoplasty and 48 cases of posterior pedicle screw fixation.We compared the operation time,operation bleeding volume,and incidence of postoperative cerebrospinal fluid leakage in the two groups.We also analyzed the lumbar instability and spinal cord injury score standard by the Japanese Orthopedic Association (JOA)between the two groups at 3,6, 12,and 24 months after operation.Results The results of modified expanding suspended laminoplasty group were significantly better than those of posterior pedicle screw fixation group in operation time, operation bleeding volume and incidence of postoperative cerebrospinal fluid leakage (P 0.05).At 3,6 or 12 months after the operation, changes in the increase of JOA score of the two groups had no significant difference (P > 0.05 ).However,24 mouths after the operation,the group of posterior pedicle screw fixation had significantly improved JOA score compared with that in the modified expanding suspended laminoplasty group.Conclusion Both the modified expanding suspended laminoplasty and posterior pedicle screw fixation have a favorable outcome of postoperative lumbar instability and neurofunction.And posterior pedicle screw fixation is superior to modified expanding suspended laminoplasty in improving neurofunction.

Comparison of the efficacy of intraspinal tumor resection under quadrant channel and hemilaminectomy surgery / 西安交通大学学报(医学版)

Objective To compare the clinical efficacy of intraspinal tumor resection under quadrant channel and hemilaminectomy surgery.Methods We retrospectively studied 33 patients with intraspinal tumor with the lesion length of less than 5 cm hospitalized in our hospital from July 2013 to July 201 5.Of the 33 patients,1 6 patients received intraspinal tumor resection under quadrant channel and 1 7 patients received intraspinal tumor resection under hemilaminectomy surgery.We compared various indicators in the two groups,including the length of surgical incision,surgical operation time,bleeding volume during operation,time for the first ground activity after surgery,length of hospital stay (LOS)after surgery,visual pain simulation (VAS)score 1 week after surgery, and JOA score excellent and good rates.Results The patients who received quadrant channel intraspinal tumor resection outperformed those who received hemilaminectomy surgery regarding the length of surgical incision, bleeding volume during operation,time for the first ground activity after surgery,LOS after surgery,and VAS score 1 week after surgery (P <0.05 ).Conclusion Intraspinal tumor resection under quadrant channel is a safe and effective therapy because of small trauma,less bleeding,quick recovery and curative effect.

Study of lumbar spinal stability after laminectomy in the treatment of lumbar intraspinal tumors / 医学研究生学报

Objective Laminectomy is destructive to bone structure in spine , which affect spinal stability .This article was to investigate the effect on spinal stability after laminectomy in different segments of vertebral plate in the treatment of lumbar intraspinal tumors. Methods Retrospective analysis were made on the data of 143 patients with lumbar intraspinal tumors from January 2009 to June 2012 in 6 hospitals.All the patients underwent laminectomy with no use of inner regular apparatus during the operation .JOA evalu-ation was applied to observe short-term efficacy , while ASIA scale for long-term efficacy .Comparison was made on lumbar spinal stability before operation and in the last visiting . Results From the observation of short-term efficacy, JOA evaluation score rised from (1.12 ± 0.65)to (1.97 ±0.71).Form the observation of long-term efficacy, ASIA scale classification was as follows:4 cases of Grade I, 6 cases of Grade II, 14 cases of Grade III, 53 cases of Grade IV and 66 cases of Grade V.In the following 12-30 months′visiting, all patients were covered.In the last postoperative visiting, patients suffering spinal instability after laminectomy were as follows:2 of 45(one seg-ment), 9 of 47(two segments), 5 of 27 (three segments) and 2 of 14 (four segments).From the observation on the postoperative spinal sta-bility and the segments in laminectomy , spinal stability of one-segment group was significantly higher than that of multi-segment group ( P=0.047).No significant difference exist between the groups of less than 2 segments and more than 3 segments as well as the groups of less than 3 segments and more than 4 segments. Conclusion A single seg-ment laminectomy on lumbar intraspinal tumors showed good postopera-tive spinal stability .But laminectomy in two or more segments implied greater risk of postoperative spinal instability .

The application of hemilaminectomy approach in intraspinal tumor / 中国医师进修杂志

Objective To investigate the therapeutic effect of the hemilaminectomy approach in intraspinal tumor with the help of intraoperative ultrasound,high-speed drill and ultrasound knife.Methods Clinical data of 35 cases with the intraspinal tumor were analyzed retrospectively.All the patients were treated by hemilaminectomy approach,the position of the lesions were fixed by preoperative X-ray and intraoperative ultrasound,root of the spinous process were removed in order to achieve adequate visual field by high-speed drill and ultrasound knife.Electrophysiologic monitoring were used if the lesions were in the spinal cord.Results Total surgical resection was achieved in 32 cases,gross total resection was in 3 cases.Twenty-eight of the 35 cases were followed up.The symptom alteration of the first period ( 1 - 3 months postoperative):improved in 25 cases,no changed in 2 cases,aggravated in 1 case.The symptom alteration of the second period (6-24 months postoperative):no changed in all cases,no stability change of the vertebral column had been found.Conclusions Followed with the development of the electrophysiologic monitoring,high-speed drill,intraoperative ultrasound,the indication of the hemilaminectomy and have no influence of the spinal stability.However,to spinal meningioma which have a wide base,the hemilaminectomy approach may not adapt.

Application of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery / 中国综合临床

Objective To evaluate the surgical technique of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery. Methods From August, 2007 to March, 2009, 11patients underwent intraspinal tumor surgery with osteotomy and reconstruction of laminar roof, titanium miniplates were used for fixing in the re-implantation. There were 2 intramedullary tumors,9 extramedullary tumors. The target of surgery was the cervical spine in 2 cases, the cervicothoracic spine in 4 cases, the thoracic spine in 2 cases, the thoracolumbar spine in 2 cases, and the lumbar spine in 1 cases. The patitens were followed up for 6 months to 2years. Local pain,bony healing and spinal malformation were assessed. Results In the 11 patients, there was no case of dural, nerve root, or spinal cord injury due to laminar roof reconstruction. One patient complained of moderate to severe local pain during follow-up and 2 patients complained of occasional slight pain at the surgical site. No limitation of activity occurred. Bony healing was confirmed radiologically or CT scan in 9 patients. There were no patients demonstrated a new spinal malalignment, and no patients developed stenosis of the spinal canal. Conclusions The reconstruction of the laminar roof using titanium miniplates will benefit the recovery of normal structure of spine,and maintain the stability of spine,and avoid the occurrence of stenosis of the spinal canal.

Incidental Intraspinal Tumor Detection during Treatment of Myofascial Pain Syndrome : A case report

Differential diagnosis of posterior neck and occipital pain is difficult based on symptoms and physical examination only. We report a case of patient who complained of pain in the posterior neck and occiput, with the initial diagnosis of myofascial pain syndrome, but who did not improve with conventional treatments. Magnetic resonance imaging revealed a cervical intraspinal tumor, and the patient developed subsequent motor weakness and sensory changes. Comprehensive diagnostic approaches are strongly recommended when the patient manifests symptoms unresponsive to treatment.

Manifestation of clinical imageology and surgical treatment of the sacral epidural cystis(18 cases and literature summary) / 中国矫形外科杂志

[Objective]To analyze the clinical diagnosis and therapic level,the clinical manifestation,image manifestation and surgical treatment of the sacral epidural cystis.[Method]Eighteen cases with the sacral epidural cystis were analyzed retrospectively,17 cases(95%)with dull pain of the lumbosacral area,16 cases(90%)with radiated pain of the lower limbs and intermittent limping,14 cases(77%)with functional lesion of the nerves,2 cases(11%)with tumor of pelvic,cavity or hypogastrium.All of them were taken AP views of X-ray,17 cases taken two-dimentional CT scannings,11 cases taken MRI,7 cases taken myelography and 4 cases taken CTM scannings.[Result]The rate of the error diagnosis was 78% in the clinic,while the success diagnosis rate was 17% in the X-ray,72% in the CT,100% in the MRI,myelography and CTM.The exairesis were done in all the 18 cases,and the epidural cystis were diagnosed in pathology.No reoccurrance was found at 15~32 months follow-up.[Conclusion]There are characteristic changes in the imageology and clinic of the sacral epidural cystis.Using minimall invasive surgery(laparoscope vertebroscope and epiduroscopy)has no confirm result till now.Microsurgical techniques contribute to the improvement of the total removal rates for the intraspinal tumors.So operation is reliable method to treat this disease and to prevent its recurring.

Diagnosis and surgical treatment of subdural-extramedullary tumor / 中国矫形外科杂志

[Objective]To investigate the diagnosis,surgical procedure and clinical effect for the subdural extramedullary tumor. [Methods]Forty-five patients (28 males and 17 females,age ranged from 24-71 years with an average of 45 years ) were treated with tumour extirpation. MRI showed subdural extramedullary tumor before surgery. The spine was exposed through a standard posterior approach,and the dura matter was opened after lamninectomy. The tumor was separated and removed from the dura matter. Pedicle screw fixation was performed to restore the stability of spine. [Results]The patients were followed up from 6 to 42 months with an average of 26.2 months. The postoperative recovery of neurological function was measured with Otani scores. The clinical result was excellent in 11 patients,good in 18 and fair in 12,resulting in 64.44% of good to excellent rate. The good to excellent rate had an advantage in patients (84.62%) operated on within one month after first visit over that of patients (64.29%) who had a misdiagnosis for 1~6 months and the patients (50.00%) for more than 6 months.[Conclusion]Removal is the method of choice for patients with subdural extramedullary tumor. Early diagnosis and removal are key factors to get a good clinical effect.

Microsurgical treatment of tumors in upper cervical spinal canal / 中国微创外科杂志

Objective To explore surgical techniques and curative effects of microsurgical treatment for tumors in upper cervical spinal canal.Methods A total of 81 cases of tumors in upper cervical spinal canal had received microneurosurgery from January 1990 to December 2005.The operation was conducted through a posteromedial approach.A total tumor resection was performed in 73 cases of neurofibroma or neurilemmoma,3 cases of spinal meningioma,and 3 cases of ependymoma.A subtotal tumor resection was conducted in 2 cases of astrocytoma.Results A complete recovery was achieved in 75 cases,an improvement of symptoms was achieved in 4 cases,and no improvement in 2.No death was encountered.Follow-up observations were carried out in 52 cases for 3 months ～ 3 years(8.5?1.5 months).MRI examinations 3 months after operation in 15 cases found no residual or recurrent tumor.X-ray radiography under anteroposterior,lateral,and open-mouth view 6 months after operation in 32 cases showed no spinal deformation and good vertebral stability.Recurrence of intramedullary tumor was seen in 3 cases. Conclusions As long as tumors in upper cervical spinal canal are diagnosed,a microsurgical treatment should be given as early as possible.Appropriate selection of surgical approach,skillful microsurgical techniques in accordance with pathological types of lesions,and principles of minimal invasion are critical for the operation safety.

Unilateral hemilaminectomy for the microsurgical removal of cervical intraspinal tumors / 中国微创外科杂志

Objective To investigate advantages and disadvantages of unilateral hemilaminectomy for the microsurgical removal of cervical intraspinal tumors. Methods Twenty-three patients with cervical intraspinal tumors were treated microsurgically with unilateral hemilaminectomy. In condition that the vertabral lamina was kept intact in bony structure, an opening (key-hole) was made in the unilateral lamina by using a drill or a small-sized bone rongeur. Then cervical intraspinal tumors were removed via the “key-hole”. Results Tumors were completely removed in all the 23 patients and no symptoms relating nerve injuries were observed. Postoperative follow-up for 3~16 months (mean, 8 months) revealed no recurrence and spinal deformity. Conclusions Unilateral hemilaminectomy for the treatment of cervical intraspinal tumors is a mini-invasive procedure which benefits the spinal stability. The pitfall of the technique lies in limited surgical field.

A Case of Cauda Equina Schwannoma Presenting as Normal Pressure Hydrocephalus

A 61-year-old man presented with cognitive dysfunction and an 8-month history of progressive gait disturbance. Brain MRI revealed communicating hydrocephalus. Under the impression of normal pressure hydrocephalus, cerebrospinal fluid (CSF) study was done and showed unusually increased opening pressure (40 cm H2O) and protein concentration (650 mg/dl). Spine MRI was performed to rule out the possibility of intraspinal tumor. It revealed cauda equina mass, which was confirmed to be schwannoma pathologically. Intraspinal tumor should be suspected in patients with abnormally increased CSF opening pressure and/or CSF protein who presented as normal pressure hydrocephalus.

Microinvasive therapy for intraspinal tumors resection via Key-hole on mono-lamina / 中华显微外科杂志

Objective To research the microinvasive therapy for intraspinal tumors resection and study the ways for spinal function protection. Methods Twenty-four cases were detected by MR. The intraspinal tumors located variously and the size of them ranging from 0.9 cm to 3.0 cm. All the tumors underwent resection via Key-hole on mono-lamina and the clinical data were analyzed. Results After tumor pathological examination,the cases of neurofibroma,neurinoma,and spinal meningioma were 9,12 and 3 cases. respectively. All the patient recovered and they walked within one week after operation. No recurrenced on MR examination after 3 months and no spinal tube destruction on CT examination after 6 months. Conclusion The microinvasive therapy via Key-hole on mono-lamina is benefic to the totally resection of intraspinal tumors and also benific to the spinal function protection.

Intraspinal Tumors in Children: Clinical Analysis of 24 Cases(1973~1986)

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.