• Fadi Hanbali, Daryl R Fourney, Eric Marmor, Dima Suki, Laurence D Rhines, Jeffrey S Weinberg, Ian E McCutcheon, Ian Suk, and Ziya L Gokaslan.
• Department of Neurosurgery, University of Texas Medical Branch at Galveston, Galveston, TX, USA.
• Neurosurgery. 2002 Nov 1; 51 (5): 1162-72; discussion 1172-4.

ObjectiveSeveral authors have noted increased neurological deficits and worsening dysesthesia in the postoperative period in patients with spinal cord ependymoma. We describe the neurological progression and pain evolution of these patients over the 1-year period after surgery. In addition, our favored method of en bloc tumor resection is illustrated, and the rate of complications, recurrence, and survival in this group of patients is addressed.MethodsWe operated on 26 patients (12 male and 14 female) with low-grade spinal cord ependymomas between 1975 and 2001. The median age at diagnosis was 42 years. Tumors extended into the cervical cord in 13 patients, the thoracic cord in 7 patients, and the conus medullaris in 6 patients. Eleven patients had previous surgery and/or radiation therapy.ResultsWe achieved a gross total resection in 88% of patients, whereas 8% had a subtotal resection and 4% had a biopsy. Only 1 patient developed a recurrence over a mean follow-up period of 31 months.ConclusionWe conclude that radical surgical resection of spinal cord ependymomas can be safely achieved in the majority of patients. A trend toward neurological improvement from a postoperative deficit can be expected between 1 and 3 months after surgery and continues up to 1 year. Postoperative dysesthesias begin to improve within 1 month of surgery and are significantly better by 1 year after surgery. The best predictor of outcome is the preoperative neurological status.

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