Clinical Characteristics And Treatment Strategies Of Ependymoma In The Spinal Cord

Objective: To explore the clinical characteristics and clinical treatments strategies of ependymoma in the spinal cord.Methods: The clinical and follow-up data of 34 patients with ependymoma in the spinal cord,admitted to our hospital from July 2011 to September 2016,were analyzed retrospectively.All patients were operated under nerve electrophysiological monitoring,and several patients with less than 95%tumor resection accepted adjuvant radiotherapy.Results: Postoperative pathological results indicated ependymoma in all patients,including one with WHO I,30 with WHO II,and 3 with WHO III.Total tumor removal was achieved in 20 patients.subtotal removal(more than95%)in 10 and big partial removal(80%-95%)in 4.Seven patients occurred postoperative complications,including 3 with cerebrospinal fluid infection,2 with paraplegia and 2 with rectal bladder dysfunction;5 occurred in patients with total tumor removal and 2 occurred in patients with subtotal removal.Spinal cord functions were significantly improved in 20 patients,unchanged in 7 and deteriorated in 7 when they left hospital.In the follow up of(30.5±18)months,4 patients with subtotal removal were recurrent,and 4 big partial removal patients received radiotherapy after a month were without recurrence at present.Conclusions: Total tumor removal with capsule or pseudocapsule by microsurgery is the most effective treatment for ependymoma in the spinal cord.For a small number of tumors whose margins are not clear,better neurological functions could be preserved and postoperative quality of life could be improved by undergoing subtotal removal and adjunctive radiotherapy.