Surgical technique and outcomes in the treatment of spinal cord ependymomas, part 1: intramedullary ependymomas.

摘要: BACKGROUND: Intramedullary spinal ependymomas are rare tumors. OBJECTIVE: To provide a large retrospective review in the modern neuroimaging era from tertiary center where aggressive surgical resection is favored. METHODS: Charts of intramedullary treated between 1983 and 2006 were reviewed. RESULTS: Sixty-seven cases The mean age was 45.6 years (range, 11-78 years) with male-to-female ratio 2:1. most common location cervical spine, followed by thoracic lumbar spine. average duration symptoms 33 months, symptom being pain and/or dysesthesias, weakness, numbness, urinary or sexual symptoms. Gross total achieved 55 patients subtotal performed 12 patients; 9 adjuvant radiation therapy. Mean follow-up 32 months. McCormick neurological grade at last 2.0. preoperative outcome correlated significantly postoperative (P , .001). A significant number who initially worsened improved their 3-month examination. Outcomes worse undergoing without therapy .05). There 3 recurrences. overall complication rate 34%. primary complications wound infections cerebrospinal fluid leaks. CONCLUSION: Spinal cord difficult lesions to treat. Aggressive associated high rate. However, when gross can be achieved, outcomes excellent recurrence low.