Resection of cervical ependymoma

Lanzino, Giuseppe; Morales-Valero, Saul F.; Krauss, William E.; Campero, Mario; Marsh, W. Richard

doi:10.3171/2014.v3.focus14378

Cited by 3 publications

(1 citation statement)

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“…Authors have previously reported using ultrasound for resection of intramedullary lesions such as tumors and cavernomas, extramedullary lesions such as posttraumatic cysts, placement of syringo-subarachnoid shunts, and also the obliteration of spinal dural arteriovenous fistulae. [10][11][12]14,[16][17][18][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Typically, when preparing for intradural surgery, the bony exposure is planned based on a preoperative CT or MRI. A durotomy is then made by roughly approximating where the lesion should be based on adjacent landmarks.…”

Section: Intradural Mass Lesionsmentioning

confidence: 99%

Use of Intraoperative Ultrasound During Spinal Surgery

Vasudeva

Abd-El-Barr

Pompeu

et al. 2017

Global Spine Journal

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Study Design:Review and technical report.Objective:Intraoperative ultrasound has been used by spine surgeons since the early 1980s. Since that time, more advanced modes of intraoperative imaging and navigation have become widely available. Although the use of ultrasound during spine surgery has fallen out of favor, it remains the only true real-time imaging modality that allows surgeons to visualize soft tissue anatomy instantly and continuously while operating. It is our objective to demonstrate that for this reason, ultrasound is a useful adjunctive technique for spine surgeons, especially when approaching intradural lesions or when addressing pathology in the ventral spinal canal via a posterior approach.Methods:Using PubMed, the existing literature regarding the use of intraoperative ultrasound during spinal surgery was evaluated. Also, surgical case logs were reviewed to identify spinal operations during which intraoperative ultrasound was used. Illustrative cases were selected and reviewed in detail.Results:This article provides a brief review of the history of intraoperative ultrasound in spine surgery and describes certain surgical scenarios during which this technique might be useful. Several illustrative cases are provided from our own experience.Conclusions:Surgeons should consider the use of intraoperative ultrasound when approaching intradural lesions or when addressing pathology ventral to the thecal sac via a posterior approach.

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Section: Intradural Mass Lesionsmentioning

confidence: 99%

Use of Intraoperative Ultrasound During Spinal Surgery

Vasudeva

Abd-El-Barr

Pompeu

et al. 2017

Global Spine Journal

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C4 to C7 Laminoplasty for Resection of an Intradural Intramedullary Ependymoma: 2-Dimensional Operative Video

Peeters,

Batzdorf,

Holly

2024

Operative Neurosurgery

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A 28-year-old woman with a history of a prolactinoma presented with about 5 months of neck pain and left upper extremity numbness and tingling in the C7 and C8 dermatomal distribution. She had no weakness on examination though notable increased deep tendon reflexes in the lower extremities. She had a homogenously enhancing lesion with an associated syrinx on MRI of her cervical spine. She was offered a C4–7 laminoplasty for resection of the tumor and ultimate tissue diagnosis. The patient consented to the procedure. Her postoperative imaging was notable for gross total resection and significant improvement of the syrinx and cervical alignment. Clinically, her paresthesias and gait improved significantly. The pathology confirmed a diagnosis of World Health Organization grade II ependymoma. The management of ependymomas in adults often starts with surgical resection for cytoreduction followed by postoperative radiotherapy for World Health Organization grade II and grade III at least. 1-4 Spinal cord ependymomas tend to have favorable prognosis, except when carrying an MYCN gene amplification. 5,6

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Microsurgery resection of giant cervicothoracic spinal ependymoma: Two-dimensional operative video

Habib,

Deng,

Hameed

et al. 2024

Surgical Neurology International

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Background: Ependymomas, rare glial brain tumors, account for <5% of all brain tumors. Interestingly, over 60% of ependymomas occur in the spinal cord of adults, including those originating from the filum terminale, while the rest are found within the brain. The World Health Organization (WHO) categorizes ependymomas into three grades: subependymomas and myxopapillary ependymomas ([MEPNs]; WHO grade I), classic ependymomas (WHO grade II), and anaplastic ependymomas (WHO grade III). Spinal ependymomas generally exhibit a more favorable prognosis compared to their intracranial counterparts and are primarily treated through gross total resection, which is considered the most effective surgical approach. As such, they are recognized as a distinct clinical entity that demands tailored management strategies. MEPNs, which constitute 13% of ependymomas, typically occur in the cauda equina and sometimes extend into the conus medullaris. Most other spinal ependymomas are of the classic type and predominantly arise in the cervical and thoracic regions of the spine. The mean age at diagnosis is 45 years of age. While prognosis varies based on molecular subtypes, complete resection is associated with improved survival. Case Description: Here, we demonstrate the technical nuances to safely achieve gross total resection of a giant spinal ependymoma in a 29-year-old female with a medical history notable for sept-optic dysplasia, and panhypopituitarism. The patient presented with progressive neck pain, upper and lower extremity weakness, and numbness for 1 year. On physical examination, she demonstrated mild weakness in her left arm. The preoperative magnetic resonance imaging revealed a cervicothoracic intramedullary mass extending from C4 to T2 with an associated syrinx at C4. Under intraoperative neural monitoring (somatosensory evoked potentials, motor-evoked potentials, and epidural direct wave recordings), the patient underwent a C4 – T2 laminectomy. In addition, spinal ultrasonography helped differentiate solid tumor mass from syrinx formation, thus guiding the focus and extent of the decompression . Conclusion: Gross total resection was achieved; at 18 postoperative months, the patient had mild residual motor deficit. The pathological evaluation revealed a WHO grade II ependymoma. Subsequent sequential enhanced MR studies at 3, 6, and 12 months confirmed no tumor recurrence.

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Resection of cervical ependymoma

Cited by 3 publications

References 0 publications

Use of Intraoperative Ultrasound During Spinal Surgery

Use of Intraoperative Ultrasound During Spinal Surgery

C4 to C7 Laminoplasty for Resection of an Intradural Intramedullary Ependymoma: 2-Dimensional Operative Video

Microsurgery resection of giant cervicothoracic spinal ependymoma: Two-dimensional operative video

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