Neurofibroma

Pediatric spinal neurofibromas are benign nerve sheath tumors that arise from the spinal nerves. While most are noncancerous, they can grow large enough to compress the spinal cord or nerve roots, leading to pain, weakness, sensory disturbances, or spinal deformity. In some cases, spinal neurofibromas are associated with Neurofibromatosis Type 1 (NF1)—a genetic condition that causes tumors to form on nerves throughout the body. In Bangladesh, pediatric spinal tumors are often under-recognized or misdiagnosed due to lack of awareness and specialized neurosurgical services. Dr. Md. Nafaur Rahman, one of Bangladesh's leading pediatric neurosurgeons, offers state-of-the-art diagnostic and microsurgical treatment for spinal neurofibromas in children, providing hope for affected families across the country. What is a Spinal Neurofibroma? A neurofibroma is a benign, slow-growing tumor that originates from the nerve sheath. In the spine, these tumors most commonly develop: Along the spinal nerve roots (intradural or extradural) Within the spinal canal (intradural extramedullary) Sometimes may extend through the neural foramen and appear as dumbbell-shaped tumors In pediatric patients, spinal neurofibromas are often associated with NF1, a genetic disorder characterized by multiple tumors, skin changes (café-au-lait spots), and other neurological issues. Causes and Risk Factors Neurofibromatosis Type 1 (NF1) – most common risk factor Spontaneous (non-syndromic) neurofibromas are rare in children Family history of neurofibromatosis Congenital nerve sheath anomalies Common Locations Cervical spine – may cause neck pain and arm weakness Thoracic spine – may present with back pain and walking difficulties Lumbosacral spine – may affect bladder/bowel control and leg strength May be multiple, especially in NF1 Symptoms in Children Pediatric spinal neurofibromas can present with a range of signs and symptoms depending on their location and size: Persistent back or neck pain Limb weakness or numbness Gait disturbances and frequent falls Bladder or bowel dysfunction Spinal deformities or scoliosis Palpable mass or swelling in the spine in some cases Skin changes (café-au-lait spots, axillary freckling) if associated with NF1 Early diagnosis is critical to prevent permanent neurological deficits. Unfortunately, in Bangladesh, delayed presentation is common due to low public and primary care awareness. Diagnosis in the Bangladeshi Context Dr. Md. Nafaur Rahman adopts a comprehensive and child-friendly approach to diagnosing spinal neurofibromas: 1. Clinical Examination Detailed neurological assessment Examination for NF1-related skin and eye findings Gait and motor function evaluation Family history inquiry 2. Imaging Studies MRI of the spine with contrast – gold standard to assess tumor size, shape, and relation to spinal cord and nerve roots CT scan – helpful for bony involvement and dumbbell-shaped tumors Spinal ultrasound – occasionally useful in infants 3. Genetic Testing May be recommended in suspected NF1 cases Ophthalmologic and dermatologic evaluations may be advised Surgical Treatment Options Surgery is the mainstay treatment for symptomatic or growing spinal neurofibromas in children. Objectives of Surgery: Complete or subtotal tumor resection Decompression of spinal cord and nerve roots Prevention of neurological deterioration Correction of spinal deformities if needed Dr. Nafaur Rahman’s Expertise in Surgery: Microsurgical tumor removal under high magnification Use of intraoperative neuro-monitoring for nerve preservation Laminoplasty or laminectomy based on tumor location Minimally invasive techniques in selected cases Multidisciplinary follow-up with neurology and rehabilitation teams Postoperative Care and Recovery Most children experience neurological improvement within weeks Rehabilitation therapy is essential for motor recovery Long-term follow-up for recurrence monitoring and NF1-related issues Psychosocial support and education for families in NF1 cases Challenges in Bangladesh Lack of awareness among general physicians and pediatricians Delayed referrals from rural healthcare centers Limited pediatric MRI access outside urban areas Cultural stigma associated with genetic disorders like NF1 Limited rehabilitation services in many districts Why Choose Dr. Md. Nafaur Rahman? Highly experienced in treating pediatric spinal tumors using advanced microsurgical techniques Performs surgeries at National Institute of Neurosciences & Hospital (NINS) and Bangladesh Paediatric Neurocare Centre Offers a multidisciplinary treatment approach, including neurogenetics and neurorehabilitation Known for affordable, ethical, and compassionate care for children and their families Committed to improving awareness and early intervention across Bangladesh Appointment and Contact Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery National Institute of Neurosciences & Hospital (NINS) Chief Consultant, Bangladesh Paediatric Neurocare Centre 📞 For Appointment/Serial: 01912988182 | 01607033535 🌐 Website: www.neurosurgeonnafaur.com