title: The surgical strategy for eosinophilic granuloma of the pediatric cervical spine complicated with neurologic deficit and/or spinal instability.
abstract: BACKGROUND
  Various therapeutic approaches have been proposed for the treatment of pediatric patients with eosinophilic granuloma (EG) of the cervical spine. Our aim was to discuss and present our experience with the individualized surgical intervention of pediatric cervical EG complicated with neurologic deficits and/or spinal instability.
  
  
  METHODS
  We retrospectively analyzed the clinical data of 19 children who were diagnosed with cervical EG comor spinal/or spinal instability (evaluated by the Spinal Instability Neoplastic Score, SINS ≥ 7) and treated surgically in our institution.
  
  
  RESULTS
  Lesions involved C1-2 in 7 patients and C3-7 in 12 patients. Anterior tumor resection combined with posterior pedicle screw fixation, anterior approach of excision and instrumentation, and posterior tumor resection combined with pedicle screws instrumentation were selected according to the different locations of tumors. Frankel scale and Oucher scale improved significantly after surgery. There was no morphologic alteration of the neck at follow-up.
  
  
  CONCLUSIONS
  Surgery can significantly improve the neurologic status and symptoms. Surgical decision-making must be individually tailored to minimize the influence of surgery on spine growth.
authors.affiliation: Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Nanzhe
authors.initials: N
authors.lastname: Zhong
authors.affiliation: Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Tong
authors.initials: T
authors.lastname: Meng
authors.affiliation: Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Xinghai
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
authors.forename: Wangjun
authors.initials: W
authors.lastname: Yan
authors.affiliation: Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China. jianruxiao83@163.com.
authors.forename: Jianru
authors.initials: J
authors.lastname: Xiao
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D000066491:Clinical Decision-Making; D004803:Eosinophilic Granuloma / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology / Q000601:surgery*; D061646:Operative Time; D057285:Precision Medicine; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000150:complications / Q000601:surgery*
keywords: Cervical; Eosinophilic granuloma; Pediatric; Surgery