gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Regional spinal cord atrophy is associated with poor outcome after surgery on intramedullary spinal cord ependymoma: a new aspect of delayed neurological deterioration

Meeting Abstract

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  • Bedjan Behmanesh - Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Johanna Quick-Weller - Frankfurt, Deutschland
  • Andrea Spyrantis - Frankfurt, Deutschland
  • Florian Gessler - Frankfurt, Deutschland
  • Lioba Imöhl - Frankfurt, Deutschland
  • Volker Seifert - Frankfurt, Deutschland
  • Gerhard Marquardt - Frankfurt, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP 113

doi: 10.3205/17dgnc676, urn:nbn:de:0183-17dgnc6768

Published: June 9, 2017

© 2017 Behmanesh et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: A considerable number of patients suffer delayed neurological deficits even after a successful removal of intramedullary spinal cord ependymoma. The underlying pathology remains unknown. Radiological findings could be an explanation for poor outcome after surgery on intramedullary spinal cord ependymoma.

Methods: We conducted a retrospective study of all cases treated from 1980 to 2016 in our department. Included were all patients with intramedullary spinal cord ependymoma treated with microsurgical excision. The cross-sectional area (CSA) of the spinal cord at the level of the former performed surgery was compared in MRI scans with postoperatively, adjacent not affected levels and with control group.

Results: 54 patients with an intramedullary spinal cord lesion were treated in this period. Ependymoma was the predominant tumor (28) followed by intramedullary gliomas and vascular lesions. Mean age was 48.2 ± 10.5 years with a female predominance (f=16, m=12). An unfavorable outcome was observed in 53% of the patients after an initially uneventful postoperative course. The cross-sectional area of the spinal cord was significantly reduced in these patients. Sagittal and axial spinal MRI showed spinal cord narrowing due to atrophic changes in the area of the performed surgery in 53 % of patients with resected ependymoma after a mean follow-up time of 9 years. Functional outcome in ependymoma was significantly associated with spinal cord atrophy (p< 0.05).

Conclusion: Spinal cord atrophy seems to be a predicting factor in long term outcome after surgical removal of intramedullary spinal cord ependymoma.