TY - JOUR
T1 - Poor Prognostic Factors for Surgical Treatment of Spinal Intramedullary Ependymoma (World Health Organization Grade II)
AU - Tsuji, Osahiko
AU - Nagoshi, Narihito
AU - Ishii, Ryota
AU - Nori, Satoshi
AU - Suzuki, Satoshi
AU - Okada, Eijiro
AU - Fujita, Nobuyuki
AU - Yagi, Mitsuru
AU - Matsumoto, Morio
AU - Nakamura, Masaya
AU - Watanabe, Kota
N1 - Publisher Copyright:
© 2020. by Korean Society of Spine Surgery. All Rights Reserved.
PY - 2020
Y1 - 2020
N2 - Study Design: Single-center retrospective study. Purpose: We aimed to explore the postoperative prognostic factors for spinal intramedullary ependymoma. Overview of Literature: Ependymoma (World Health Organization grade II) is the most frequent intramedullary spinal tumor and is treated by total resection. However, postoperative deterioration of motor function occasionally occurs. Methods: Eighty patients who underwent surgical resection at Keio University and Fujita Health University in Tokyo, Japan between 2003 and 2015 with more than 2 years of follow-up were enrolled. A good surgical result was defined as an improvement in the modified McCormick Scale score by one grade or more or having the same clinical grade as was observed preoperatively. Meanwhile, a poor result was defined as a reduction in the McCormick Scale score of one grade or more or remaining in grade IV or V at final follow-up. Univariate and multivariate logistic regression analyses of the following factors were performed in the two groups: sex, age, preoperative Visual Analog Scale (VAS), tumor location, the extent of tumor resection, hemosiderin caps, cavity length, and tumor length on magnetic resonance imaging. Results: At final follow-up, 15 patients were included in the poor results group and 65 in the good results group. In the univariate analysis, the factors related to poor results were as follows: higher age, preoperative McCormick Scale score severity, higher preoperative VAS, thoracic location, hemosiderin capped, and non-gross total resection (GTR). A multiple logistic regression analysis was conducted and showed that age, worse preoperative McCormick Scale score, and non-GTR were significant factors for poor prognosis. Conclusions: The independent risk factors for motor deterioration after ependymoma resection were age, worse preoperative Mc-Cormick Scale score, and non-GTR. Early surgery for patients with even mild neurological disorders could facilitate functional outcomes. These results may contribute to determining the optimal timing of surgery for spinal intramedullary ependymoma.
AB - Study Design: Single-center retrospective study. Purpose: We aimed to explore the postoperative prognostic factors for spinal intramedullary ependymoma. Overview of Literature: Ependymoma (World Health Organization grade II) is the most frequent intramedullary spinal tumor and is treated by total resection. However, postoperative deterioration of motor function occasionally occurs. Methods: Eighty patients who underwent surgical resection at Keio University and Fujita Health University in Tokyo, Japan between 2003 and 2015 with more than 2 years of follow-up were enrolled. A good surgical result was defined as an improvement in the modified McCormick Scale score by one grade or more or having the same clinical grade as was observed preoperatively. Meanwhile, a poor result was defined as a reduction in the McCormick Scale score of one grade or more or remaining in grade IV or V at final follow-up. Univariate and multivariate logistic regression analyses of the following factors were performed in the two groups: sex, age, preoperative Visual Analog Scale (VAS), tumor location, the extent of tumor resection, hemosiderin caps, cavity length, and tumor length on magnetic resonance imaging. Results: At final follow-up, 15 patients were included in the poor results group and 65 in the good results group. In the univariate analysis, the factors related to poor results were as follows: higher age, preoperative McCormick Scale score severity, higher preoperative VAS, thoracic location, hemosiderin capped, and non-gross total resection (GTR). A multiple logistic regression analysis was conducted and showed that age, worse preoperative McCormick Scale score, and non-GTR were significant factors for poor prognosis. Conclusions: The independent risk factors for motor deterioration after ependymoma resection were age, worse preoperative Mc-Cormick Scale score, and non-GTR. Early surgery for patients with even mild neurological disorders could facilitate functional outcomes. These results may contribute to determining the optimal timing of surgery for spinal intramedullary ependymoma.
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U2 - 10.31616/ASJ.2020.0064
DO - 10.31616/ASJ.2020.0064
M3 - Article
AN - SCOPUS:85099602328
SN - 1976-1902
VL - 14
SP - 821
EP - 828
JO - Asian Spine Journal
JF - Asian Spine Journal
IS - 6
ER -