Intramedullary spinal cord tumors are rare and inspire respect in all neurosurgeons. Nevertheless, accumulated surgical experience and technological advances have resolved crucial steps for neurologically safe and oncologically sound treatment. Since the great majority of intramedullary tumors in children and adults are benign and slow growing, surgery appears to be the most effective treatment to control them, overall far superior to the attempts to arrest growth with fractionated radiation therapy. This applies to ependymomas, the most frequent tumor of adult age as well as to low grade astrocytic tumors, the most frequent intramedullary tumor in childhood.
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