Spinal ependymomas length matters: 5 findings on surgical strategies

The study included 210 patients with spinal ependymomas in a 10-year retrospective analysis. The patients were divided according to length — 5 cm, 5 to 10 cm, more than 10 cm — and all patients underwent tumor resection.

Grosstotal resections were performed for 172 patients with subtotal and partial resections achieved in 38 patients:

•    5 cm: 86.5 percent
•    5 cm to 10 cm: 79 percent
•    More than 10 cm: 77.5 percent

There were eight patients with medulla oblongata or upper cervical cord tumors that received postoperative tracheotomy. The patients were followed for 56 months to 176 months. The researchers found:

1. Around 76.7 percent of the patients experienced improvement postoperatively. Improvement broken down by ependymoma length was:

•    5 cm: 88.2 percent
•    5 cm to 10 cm: 83.8 percent
•    More than 10 cm: 34.4 percent

2. Another 18.8 percent of the patients maintained pretreatment status while 4.5 percent of the patients showed determination after the tumor resection at six months.

3. Tumor recurrence or progression was observed in six patients — 2.9 percent. Among those patients:

•    Three were located in the conus
•    One was located in the thoracic
•    Two were located in the medullocervical

4. More postoperative and neuropathic pain and preoperative deficits were observed in patients with larger tumors. However the researchers still concluded radical resection of the spinal ependymomas could be performed in most patients.

5. The researchers concluded early diagnosis and timely operation was critical for better outcomes. "For tumors with dense adhesions, complete removal should be performed cautiously because of the significant incidence of neurological deterioration."

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