{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:13:24Z","timestamp":1788509604996,"version":"build-2803163510"},"reference-count":18,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pediatric primary spinal cord tumors are rare, accounting for approximately 6% of central nervous system neoplasms. Most published data come from high-income countries (HICs) with access to early diagnosis, intraoperative monitoring, and specialized neuro-oncology units. In low- and middle-income countries (LMICs), diagnostic and therapeutic resources are limited. This report summarizes the first cohort of pediatric cases from Pakistan, highlighting surgical outcomes and systemic challenges in a resource-constrained setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of patients \u226418 years who underwent surgery for primary pediatric spinal tumors at a tertiary hospital in Karachi (2008\u20132025). Demographics, presentation, tumor location and compartment, histopathology, extent of resection, postoperative complications, adjuvant therapy status, mortality, recurrence\/progression, and follow-up outcomes were extracted from records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Nineteen children were included (11 female; median age, 12 years). Lower-limb weakness (\n                      <jats:italic>n<\/jats:italic>\n                      = 11) and back pain (\n                      <jats:italic>n<\/jats:italic>\n                      = 7\/15 with available data) were the most common presentations, with a median diagnostic delay of 90 days. Tumors were most often lumbar (\n                      <jats:italic>n<\/jats:italic>\n                      = 6), cervical (\n                      <jats:italic>n<\/jats:italic>\n                      = 5), or thoracic (\n                      <jats:italic>n<\/jats:italic>\n                      = 5). Among 13 patients with documented compartment data, 7 tumors were intramedullary, 4 were extramedullary\/intradural or paramedullary, and 2 were intradural without further compartment specification. Ependymoma (\n                      <jats:italic>n<\/jats:italic>\n                      = 5) and astrocytoma (\n                      <jats:italic>n<\/jats:italic>\n                      = 4) predominated. Gross total resection (GTR) was documented in 10 patients and maximal safe\/subtotal resection (MSR\/STR) in 7. Postoperative complications were documented in 2\/16 patients with available data. At the last follow-up, 5\/12 patients with neurological follow-up improved, 5 remained stable, and 2 worsened. Mortality was documented in 5\/17 patients with survival status available patient had recurrence after GTR, and 1 had progression after MSR\/STR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Surgical management of pediatric primary spinal tumors in an LMIC tertiary center was feasible, with limited documented perioperative morbidity after data correction. However, small sample size, missing event-level data, and a short median follow-up of 4 months limit interpretation of recurrence, progression-free status, and mortality. Earlier diagnosis, standardized surveillance, multidisciplinary review, rehabilitation, infection prevention, and improved access to adjuvant therapy may help strengthen care pathways in resource-constrained settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_325_2026","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T07:28:11Z","timestamp":1788506891000},"page":"497","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical outcomes of primary pediatric spinal cord tumors: A retrospective cohort"],"prefix":"10.25259","volume":"17","author":[{"given":"Abrahim Danish","family":"Durrani","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahsan","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fareeha","family":"Nisar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabeet","family":"Tariq","sequence":"additional","affiliation":[{"name":"Department of Surgery, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saqib Kamran","family":"Bakhshi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Shahzad","family":"Shamim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Aga Khan University, Karachi, 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