Surgical Treatment of Ependymomas in the Cervical and Upper Thoracic Spinal Cord

Authors: P. Buchvald;  P. Suchomel;  M. Kaiser
Authors‘ workplace: Neurochirurgické oddělení, Neurocentrum, Krajská nemocnice Liberec
Published in: Cesk Slov Neurol N 2007; 70/103(2): 196-200
Category: Short Communication


Intramedullary ependymomas are the most common spinal cord tumors in the cervical and thoracic regions in adult patients. These tumors are benign, slowly growing lesions which are optimally treated with the total surgical resection without adjuvant therapy. The authors have analysed retrospectively a group of eight patients treated within 2001-2004. In two of them tumors also extended into the medulla oblongata. Six cases underwent total and two subtotal surgical removals without adjuvant therapy. The functional outcome was evaluated according to Nurick scale. Four patients without severe neurological deficit before surgery (Nurick 1-2) were improved (3) or remained unchanged (1) postoperatively. In four patients with initial serious functional deficit (Nurick 4-5) poor neurological status also persisted after a surgery. No recurrence has been observed in seven treated patients so far (one patient died of different diagnosis eight months after a surgery). In correspondence with literature our results have denoted that good initial functional status and the radical removal are the propitious prognostic factors influencing long-lasting good postoperative outcome without the tumor recurrence.

Key words:
ependymoma, spinal cord, surgery, laminoplasty


1. Chang UK, Choe WJ, Chung SK, Chung ChK, Kim HJ. Surgical outcome and prognostic factors of spinal intramedullary ependymomas in adults. J Neuro Oncol 2002; 57: 133-9.

2. McCormick PC, Torres R, Post KD, Stein BM. Intramedullary ependymoma of the spinal cord. J Neurosurg 1990; 72: 523-32.

3. Choi JY, Chang KH, Yu IK, Kim KH, Kwon BJ, Han MH et al. Intracranial and spinal ependymomas: review of MR images in 61 patients. Korean J Radiol 2002; 3(4): 219-28.

4. Hanbali F, Fourney DR. Spinal cord ependymoma: radical surgical resection and outcome. Neurosurgery 2002; 51(5): 1162-74.

5. Schwartz TH, McCormick P. Intramedullary ependymomas: clinical presentation, surgical treatment strategies and prognosis. J NeuroOncology 2000; 47: 211-18.

6. Schild SE, Nisi K, Scheithauer WB, Wong WW, Lyons MK, Schomberg PJ et al. The results of radiotherapy for ependymomas: The Mayo clinic experience. Int J Radiat Oncol Biol Phys 1998; 42: 953-8.

7. Epstein FJ, Farmer JP, Freed D. Adult intramedullary spinal cord ependymomas: the result of surgery in 38 patients. J Neurosurg 1993; 79: 204-9.

8. Sun B, Wang Ch, Wang J, Liu A. MRI features of intramedullary spihnal cord ependymomas. J Neuroimaging 2003; 13: 346-51.

9. Yoshii S, Shimizu K, Ido K, Nakamura T. Ependymoma of the spinal cord and the cauda equina region. J Spin Disord 1999; 12: 157-61.

10. Raco A, Esposito V, Lenzi J, Piccirilli M, Delfini R, Cantore G. Long-term follow-up of intramedullary spinal cord tumors: a series of 202 cases. Neurosurgery 2005; 56(5): 972-81.

11. Lin YH, Huang CI, Wong TT, Chen MH, Shiau CY, Wang LW et al. Treatment of spinal cord ependymomas by surgery with or without postoperative radiotherapy. J Neurooncol 2005; 71(2): 205-10.

12. Peker S, Ozgen S, Ozek MM, Pamir MN. Surgical treatment of intramedullary spinal cord ependymomas: can outcome be predicted by tumor parameters? J Spinal Disord Tech 2004; 17(6): 516-21.

13. Kyoshima K, Akaishi K, Tokushige K, Muraoka H, Oikawa S, Watanabe A et al. Surgical experience with resection en bloc of intramedullary astrocytomas and ependymomas in the cervical and cervicothoracic region. J Clin Neurosci 2004; 11(6): 623-8.

14. Haas-Kogan DA., Gomez DR, Missett BT, Wara WM, Lamborn KR, Prados MD et al. High failure rate in spinal ependymomas with long-term follow-up. Neuro-oncol 2005; 7(3): 254-9.

15. Sloof JL, Kernohan JW, McCarthy CS. Primary intramedullary tumors of the spinal cord and fillum terminale. Philadelphia: WB Saunders 1964.

16. Buchvald P, Suchomel P, Fröhlich R, Vaníčková E. Open-door laminoplastika v řešení stenózy krční páteře. Cesk Slov Neurol N 2004; 67(100): 124–31.

17. Singh A, Crockard HA. Comparison of seven different scales used to quantify severity of cervical spondylotic myelopathy and post-operative improvement. J Outcome Meas 2001-2002; 5(1): 798-818.

18. Kleihues P, Burger PC, Scheithauer BW. The new WHO classification of brain tumours. Brain Pathology 1993; 3: 255-68.

19. Yonenobu K, Okada K, Fuji T, Fujiwara K, Yamashita K, Ono K. Causes of neurologic deterioration following surgical treatment of cervical myelopathy. Spine 1986; 11: 818–23.

20. Deletis V, Shils JL. Neurophysiology in neurosurgery. Elsevier Science (USA); 2002.

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