gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Neurological outcome following spinal intramedullary ependymoma ablation – a single centre experience

Neurologisches Outcome nach Resektion von spinalen intramedullären Ependymomen – eine monozentrische Erfahrung

Meeting Abstract

  • presenting/speaker Obada T. Alhalabi - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Vincent Landré - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Klaus Zweckberger - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Alexander Younsi - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Andreas W. Unterberg - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV235

doi: 10.3205/22dgnc227, urn:nbn:de:0183-22dgnc2270

Published: May 25, 2022

© 2022 Alhalabi 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

Text

Objective: Spinal intramedullary ependymomas represent a well-defined tumor entity usually warranting surgical resection. The perioperative morbidity and mortality, together with the oncological and neurological outcome of affected patients are seldomly reported on in larger clinical series.

Methods: A single-center retrospective analysis of all patients undergoing surgery on spinal intramedullary lesions between 2007 and 2020 was performed. Data collection included demographics, symptoms, clinical findings, histopathological diagnosis, surgical procedures, complications and neurological outcome. Patients harboring favorable (stable or change towards a better McCormick score) and non-favorable (McCormick score deterioration to ³ 2) outcomes after surgery were statistically compared.

Results: Retrospective analysis revealed 114 eligible patients of which 67 had an intramedullary ependymoma (IE). IEs in those patients (46 males and 21 females, median age 52, range 38 to 66) mostly occurred in the cervical (n=51, 43%), cervico-thoracic (n=9, 13%) or thoracic spine (n=8, 12%). Upon admission, motor deficits or gait problems (McCormick grade ³ 2) were present in 40 patients (60%). GTR was achieved in 60 (90%) patients and the rate of surgical complications was 9 %. Histopathologically, 61 (91%) tumors were classified as WHO grade 2 ependymomas and 6 (9%) as WHO grade 1 subependymomas. During a median follow-up period of 20 months (range 1 to 112 months), 60 patients (90%) showed a favorable outcome whereas 7 patients (10%) demonstrated a non-favorable outcome at their respective last follow-up. Postoperative neurological deterioration occurred in 15 patients, 8 of which re-attained their baseline neurological state in subsequent follow-ups. Comparison of favorable with non-favorable outcomes revealed no significant predictors for post-operative deterioration in univariate statistical analysis.

Conclusion: The neurosurgical resection of spinal intramedullary ependymomas bears a favorable overall neurological outcome reasonable perioperative morbidity and mortality. An early surgical intervention in symptomatic patients could help preserve long-term neurological function.

Figure 1 [Fig. 1], Figure 2 [Fig. 2]