Spinal ependymoma treatment
Spinal cord ependymoma can most often be removed completely with an acceptable surgical risk. Therefore, the recommended management approach is usually surgical excision 1).
Maximal safe resection with intraoperative neurophysiological monitoring.
Grade II and III intramedullary ependymomas [IME] are circumscribed with a plane of cleavage that should facilitate high gross total resection rates (GTR). Gross total resection of grade II/III IME is superior to subtotal resection (STR) and radiotherapy (RTx) for progression-free and overall survival 2).
Data suggest that it may be necessary to consider tumor features and the type of surgical technique used, particularly when interpreting intraoperative neurophysiologic monitoring profiles of intramedullary spinal cord tumors such as ependymomas and spinal cord hemangioblastomas 3).
A video demonstrates the technique of microsurgical resection of an intramedullary ependymoma through a posterior midline myelotomy. The video can be found here: http://youtu.be/lcHhymSvSqU
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4).