they are firm encapsulated benign tumors and total surgical removal can be achieved in most of the cases with an excellent outcome . the study included 21 patients in the pediatric age group ( < 18 years ) of spinal schwannomas who underwent surgery over 10 years from january 1998 to april 2008 in the department of neurosurgery , national institute of mental health and neurosciences , bangalore . the demographic profile , clinical features , radiological findings , operative procedures , postoperative complications , and outcome were noted and analyzed . there were a total of 21 patients with an age range of 6 - 18 years with a median age of 16 years . the duration of symptoms ranged from 1 month to 36 months with average duration of 5 months . six patients had bladder disturbances ( 29% ) and six patients had associated neurofibromatosis . among these , five had neurofibromatosis type i with multiple caf - au - lait spots and multiple subcutaneous swellings , and one had neurofibromatosis type ii with bilateral vestibular schwannomas . this patient underwent emergency decompression of the tumor and was put on ventilator . gradually the patient was weaned off from the ventilator support and made significant improvement . the predominant location was the cervical region in 10 cases ( 47% ) , followed by dorsal in 8 cases ( 38% ) . in three patients , four of the 21 patients had dumbbell schwannomas . among the 21 patients , 18 underwent laminectomy , 3 underwent laminotomy and microsurgical excision of the tumor . twenty patients underwent gross total excision and one underwent partial excision in view of tight adherence to multiple nerve roots in cervical region . the follow - up period ranged from 4 months to 56 months with average follow - up period of 38 months . motor deficits improved by at least one grade in 6 patients and by 2 grades in 10 patients . of the six patients who had bladder symptoms , four patients made improvement in urinary symptoms and two patients were on intermittent self - catheterization . x - rays of the spine was performed at follow - up and showed no signs of instability in any of the patients . follow - up mri at last follow - up revealed no recurrence in any of the patients . there were a total of 21 patients with an age range of 6 - 18 years with a median age of 16 years . the duration of symptoms ranged from 1 month to 36 months with average duration of 5 months . six patients had bladder disturbances ( 29% ) and six patients had associated neurofibromatosis . among these , five had neurofibromatosis type i with multiple caf - au - lait spots and multiple subcutaneous swellings , and one had neurofibromatosis type ii with bilateral vestibular schwannomas . this patient underwent emergency decompression of the tumor and was put on ventilator . gradually the patient was weaned off from the ventilator support and made significant improvement . the predominant location was the cervical region in 10 cases ( 47% ) , followed by dorsal in 8 cases ( 38% ) . in three patients , among the 21 patients , 18 underwent laminectomy , 3 underwent laminotomy and microsurgical excision of the tumor . twenty patients underwent gross total excision and one underwent partial excision in view of tight adherence to multiple nerve roots in cervical region . the follow - up period ranged from 4 months to 56 months with average follow - up period of 38 months . motor deficits improved by at least one grade in 6 patients and by 2 grades in 10 patients . of the six patients who had bladder symptoms , four patients made improvement in urinary symptoms and two patients were on intermittent self - catheterization . x - rays of the spine was performed at follow - up and showed no signs of instability in any of the patients . follow - up mri at last follow - up revealed no recurrence in any of the patients . spinal cord tumors are a relatively rare diagnosis and account for 1% to 10% of all pediatric central nervous system tumors . this is in contrast with adults where they constitute about 25% of primary intradural tumors . however , some studies indicate a higher incidence of spinal schwannomas in males , as reported by hori et al . ( 57% ) , and this percentage corresponds to our study in which 67% of schwannomas appeared in the female population . in our study , the majority of the patients presented with progressive compressive myelopathy ( 86% ) . the frequency of motor involvement and localized pain was much higher in our study compared with the available literature where it has ranged from 40% to 60% . the autonomic ( bowel and bladder ) involvement in our study was 29% compared to 10 - -20% in the literature . ( five had nf i and one had nf ii . ) the most common spinal tumors in nf i are neurofibromas . paraspinal neurofibromas including dumbbell - shaped tumors are commonly found in asymptomatic patients , especially at younger age groups . the most common location was the cervical region ( 47% ) followed by the dorsal region in 38% of the cases [ figure 1 ] . this differs from the available literature in which the majority of the tumors are located in the cervical and lumbar regions . according to the available literature 70 - -80% of spinal schwannomas are intradural in location and those extending through the dural aperture as the dumbbell mass involving both intradural as well as extradural space account for another 15% . intramedullary schwannomas are extremely rare . in our study , 17 patients had intradural schwannomas ( 80% ) and 4 patients ( 20% ) had dumbbell schwannomas . preoperative magnetic resonance imaging cervical spine ( post contrast- sagittal ) showing well - defined contrast enhancing intradural extradural lesion all our patients underwent surgery and excision of the tumor ( gte in 20 and ste in 1 ) ; [ figures 2 and 3 ] the outcome is comparable to the available literature and correlates with the preoperative neurological status of the patient . preoperative magnetic resonance imaging ( mri ) cervical spine ( post contrast - axial ) showing well - defined contrast enhancing intradural extradural lesion with the cord pushed to the left ( arrow ) postoperative magnetic resonance imaging ( mri ) cervical spine ( t2-weighted ) showing complete excision spinal cord tumors are a relatively rare diagnosis and account for 1% to 10% of all pediatric central nervous system tumors . this is in contrast with adults where they constitute about 25% of primary intradural tumors . however , some studies indicate a higher incidence of spinal schwannomas in males , as reported by hori et al . ( 57% ) , and this percentage corresponds to our study in which 67% of schwannomas appeared in the female population . in our study , the majority of the patients presented with progressive compressive myelopathy ( 86% ) . the frequency of motor involvement and localized pain was much higher in our study compared with the available literature where it has ranged from 40% to 60% . the autonomic ( bowel and bladder ) involvement in our study was 29% compared to 10 - -20% in the literature . ( five had nf i and one had nf ii . ) the most common spinal tumors in nf i are neurofibromas . paraspinal neurofibromas including dumbbell - shaped tumors are commonly found in asymptomatic patients , especially at younger age groups . the most common location was the cervical region ( 47% ) followed by the dorsal region in 38% of the cases [ figure 1 ] . this differs from the available literature in which the majority of the tumors are located in the cervical and lumbar regions . according to the available literature 70 - -80% of spinal schwannomas are intradural in location and those extending through the dural aperture as the dumbbell mass involving both intradural as well as extradural space account for another 15% . intramedullary schwannomas are extremely rare . in our study , 17 patients had intradural schwannomas ( 80% ) and 4 patients ( 20% ) had dumbbell schwannomas . preoperative magnetic resonance imaging cervical spine ( post contrast- sagittal ) showing well - defined contrast enhancing intradural extradural lesion in our study , the majority of the patients presented with progressive compressive myelopathy ( 86% ) . the frequency of motor involvement and localized pain was much higher in our study compared with the available literature where it has ranged from 40% to 60% . the autonomic ( bowel and bladder ) involvement in our study was 29% compared to 10 - -20% in the literature . ( five had nf i and one had nf ii . ) the most common spinal tumors in nf i are neurofibromas . paraspinal neurofibromas including dumbbell - shaped tumors are commonly found in asymptomatic patients , especially at younger age groups . the most common location was the cervical region ( 47% ) followed by the dorsal region in 38% of the cases [ figure 1 ] . this differs from the available literature in which the majority of the tumors are located in the cervical and lumbar regions . according to the available literature 70 - -80% of spinal schwannomas are intradural in location and those extending through the dural aperture as the dumbbell mass involving both intradural as well as extradural space account for another 15% . intramedullary schwannomas are extremely rare . in our study , 17 patients had intradural schwannomas ( 80% ) and 4 patients ( 20% ) had dumbbell schwannomas . preoperative magnetic resonance imaging cervical spine ( post contrast- sagittal ) showing well - defined contrast enhancing intradural extradural lesion all our patients underwent surgery and excision of the tumor ( gte in 20 and ste in 1 ) ; [ figures 2 and 3 ] the outcome is comparable to the available literature and correlates with the preoperative neurological status of the patient . preoperative magnetic resonance imaging ( mri ) cervical spine ( post contrast - axial ) showing well - defined contrast enhancing intradural extradural lesion with the cord pushed to the left ( arrow ) postoperative magnetic resonance imaging ( mri ) cervical spine ( t2-weighted ) showing complete excision