Pre-Operative Lumbar Drain Placement: A Technique for Minimizing Ischemic Spinal Cord Injury During Neuroblastoma Resection

Neuroblastoma is the most common extracranial solid tumor in children with roughly 700 new cases diagnosed yearly [1]. Ischemic injury to the spinal cord is an uncommon but potentially devastating complication of thoraco-abdominal neuroblastoma resection. The Artery of Adamkiewicz (AoA), which supplies significant inflow to the anterior spinal artery, often arises from an intercostal or lumbar artery between T9 and T12, though its origin is highly variable and the artery has been found to arise anywhere from between T5 to L2 [2].