Clinical characteristics and surgical outcomes of ependymomas in the upper cervical spinal cord: a single-center experience of 155 consecutive patients

Fei, Xiaobin; Jia, Wenqing; Gao, Heng; Yang, Chenlong; Li, Da; Qian, Zenghui; Han, Bo; Wang, Dejiang; Xu, Yulun

doi:10.1007/s10143-020-01363-7

Cited by 7 publications

(2 citation statements)

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“…A German team led by Behmanesh proposed that regional spinal cord atrophy was associated with poor long-term outcome after surgical removal of intramedullary spinal cord ependymoma [4]. Fei et al postulated the tumor-to-cord ratio might be a predictor for the surgical outcome of upper cervical ependymomas, while the logistic regression analysis yielded a negative result [8]. Arima and coworkers found that quantitative analysis of near-infrared indocyanine green angiography could predict functional outcomes after spinal ependymoma removal [2].…”

Section: Discussionmentioning

confidence: 99%

“…Due to the small sample size in the incomplete resection cohort, we failed to analyze the correlation between the extent of surgical resection and functional outcomes. Some scholars found permanent de cits after the spinal ependymoma resection was independently predicted by older age [3,8,27]. Bansal et al followed up 146 patients with spinal intramedullary tumors; they found that the surgical outcome at the last follow-up was correlated with age, sex, the preoperative functional status, tumor size, location, pathology, the extent of surgical resection, and the presence of syringomyelia [3].…”

Section: Discussionmentioning

confidence: 99%

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Multisegmental versus monosegmental intramedullary spinal cord ependymomas: perioperative neurological functions and surgical outcomes

et al. 2021

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Objectives: Multiple factors, such as tumor size, lateralization, tumor location, accompanying syringomyelia, and regional spinal cord atrophy, may affect the resectability and clinical prognosis of intramedullary spinal cord ependymomas. However, whether longsegmental involvement of the spinal cord may impair functional outcomes remains unclear. This study was aimed to compare perioperative neurological functions and long-term surgical outcomes between multisegmental ependymomas and their monosegmental counterparts.Methods: A total of 54 patients with intramedullary spinal cord ependymoma (WHO Grade II) were enrolled, and all of them underwent surgical resection. The patients were classi ed into the multisegmental group (n=40) and the monosegmental group (n=14). Perioperative and long-term (average follow-up period, 53.5 ± 18.2 months) neurological functions were evaluated using the modi ed McCormick (mMC) scale and the modi ed Japanese Orthopaedic Association (mJOA) scoring system.Results: Preoperative neurological functions in the multisegmental group were signi cantly worse than those in the monosegmental group (P < 0.05). However, postoperative short-term neurological functions, as well as long-term functional outcomes, were similar between the two groups (P > 0.05). Logistic regression analysis showed that only preoperative mMC and mJOA scores were signi cantly correlated with neurological improvement during the follow-up period (P < 0.05). Conclusion:Multisegmental involvement of the spinal cord is associated with worse neurological functions in patients with intramedullary spinal cord ependymoma, while the long-term prognosis is not affected. The preoperative neurological status of the patient is the only predictor of long-term functional improvement.

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Section: Discussionmentioning

confidence: 99%