Non-traumatic spinal cord compression in children: 45 cases

ABSTRACT

Spinal cord compression occurs rarely in childhood and the diagnosis is usually made too late. We report 45 cases of non-traumatic spinal cord compression collected in our department between January 1982 and December 2002. Mean age was 11 years old with a male sex predominance [sex-ratio 1.6]. Average delay of admission was 5 months. The most frequent complaints were gait disturbance [84.4%], pain [radicular or spinal] [66%] and sphincter dysfunction [24.4%]. Plain radiographs showed abnormalities in 46%. Magnetic resonance imaging has been more indicated since 1994. The distribution of lesions can be summerised as follows predominance of dorsal involvement [37.7%], extramedullary lesions [75.6%] tumoural aetiologies [71.5%]. Forty-three cases were operated; 40 cases via posterior approach with laminectomy [33 cases] and laminotomy [7 cases], while anterior approach was performed in only 3 cases. Postoperative course showed neurologic improvement in 11 cases [24.4%], a stationary state in 28 cases [62.2%], and 3 cases of death. Unfortunately the long term outcome could not be followed in the majority of cases