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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Surgical treatment of intramedullary ependymomas – long-term assessment of functional outcome and quality of life

Chirurgische Behandlung von intramedullären Ependymomen – eine Langzeitanalayse von funktionellem Ergebnis und Lebensqualität

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  • Alexander Younsi - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland
  • Vincent Landré - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland
  • Andreas W. Unterberg - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland
  • presenting/speaker Klaus Zweckberger - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV269

doi: 10.3205/19dgnc288, urn:nbn:de:0183-19dgnc2886

Published: May 8, 2019

© 2019 Younsi 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: Although consensus exists on the importance of surgical treatment and gross total resection (GTR) for intramedullary ependymomas (IE), data on quality of life (QoL) after surgery for these rare spinal cord tumors is sparse. Our study aims to assess QoL and functional outcome after surgical resection of IEs.

Methods: The hospital records of all adult patients undergoing surgery for IE at a single institution were retrospectively reviewed. Patients were then invited for a follow-up visit during which postoperative neurological function (McCormick) as well as QoL (ODI, WHOQOL-BREF, SF-36) were prospectively assessed.

Results: Retrospective analysis of 42 eligible patients (age 54±13 years, 60% male) revealed IE predominantly in the cervical spine (45%) with WHO grade II tumors in 86% of cases. On admission motor deficits or gait problems (McCormick grade 32) were present in 25 patients (60%). Goal of surgery was GTR in all patients and rate of surgical complications was 12%. At discharge, pain had improved in 67% of cases while McCormick grade only showed little amelioration (improvement by 31 in 8 patients). In the long-term (median follow-up 43 (1–115) months), McCormick grade further improved in 5 patients, whereas 2 cases of tumor recurrence occurred. Prospective follow-up (n=21) revealed a mean ODI score of 13±11 points (minimal disability) and a mean WHOQOL-BREF score of 66±16 points (between good/fair health status). In the SF-36 Health Survey, mean age-adjusted PCS score was comparable to the normal German population in male (50.93±10.23) as well as female (48.84±8.8) patients.

Conclusion: Surgical treatment of IEs can improve neurological function in the long-term. With GTR, tumor recurrence seems to be low. QoL after surgery is satisfactory and comparable to the age-adjusted normal population.