Spinal cord ependymoma treatment

Spinal cord ependymoma can most often be removed completely with an acceptable surgical risk. Therefore, the recommended management approach is usually surgical excision 1).

Maximal safe resection with intraoperative neurophysiological monitoring.

Grade II and III intramedullary ependymomas [IME] are circumscribed with a plane of cleavage that should facilitate high gross total resection rates (GTR). Gross total resection of grade II/III IME is superior to subtotal resection (STR) and radiotherapy (RTx) for progression-free and overall survival 2).

Data suggest that it may be necessary to consider tumor features and the type of surgical technique used, particularly when interpreting intraoperative neurophysiologic monitoring profiles of intramedullary spinal cord tumors such as ependymomas and spinal cord hemangioblastomas 3).

A video demonstrates the technique of microsurgical resection of an intramedullary ependymoma through a posterior midline myelotomy. The video can be found here: http://youtu.be/lcHhymSvSqU


Borges LF. Spinal intramedullary ependymoma: surgical approaches and outcome. J Neurosurg Sci. 2017 Jul 26. doi: 10.23736/S0390-5616.17.04162-5. [Epub ahead of print] PubMed PMID: 28748910.
Sweeney KJ, Reynolds M, Farrell M, Bolger C. Gross total resection rates of grade II/III intramedullary ependymomas using the surgical strategy of en-bloc resection without intra-operative neurophysiological monitoring. Br J Neurosurg. 2016 Dec 25:1-5. doi: 10.1080/02688697.2016.1270419. [Epub ahead of print] PubMed PMID: 28019107.
Kim DG, Son YR, Park YS, Hyun SJ, Kim KJ, Jahng TA, Kim HJ, Park KS. Differences in multimodality IONM changes between spinal intramedullary ependymoma and hemangioblastoma. J Clin Neurophysiol. 2015 Dec 11. [Epub ahead of print] PubMed PMID: 26690548.
McCormick PC. Microsurgical resection of intramedullary spinal cord ependymoma. Neurosurg Focus. 2014 Sep;37 Suppl 2:Video 9. doi: 10.3171/2014.V3.FOCUS14276. PubMed PMID: 25175587.
  • spinal_cord_ependymoma_treatment.txt
  • Last modified: 2018/10/23 19:37
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