Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025
Outcomes of initially chosen non-operative management for spinal ependymoma.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Zheng Guang-Hao, Zhang Yao-Wu, Ji Kai, Qiao Hui, Wu Xiao, Liu Yi-Xiang, Liu Wei-Hao, Wang Bo, Wang Chong, Liu Xing-Yu, Wang Yong-Zhi, Jia Wen-Qing
Аннотация
PURPOSE: With advancements in imaging, spinal ependymomas are increasingly detected early, often in asymptomatic or mildly symptomatic patients. This study evaluates the clinical and radiological outcomes in patients who initially underwent conservative management but subsequently underwent surgery due to disease progression.
METHODS: A retrospective analysis of 315 patients diagnosed between 2018 and 2023 identified 10 meeting the inclusion criteria (mean age: 51 years, range: 37-63). Three were asymptomatic, and seven had mild symptoms such as pain or numbness. The mean maximum tumor diameter on sagittal MRI was 23.5 mm. Tumor progression and symptom changes were monitored, with surgery performed as needed.
RESULTS: Over a median conservative period of 36 months, all patients eventually required surgery due to symptom progression or tumor growth, with an average tumor size increase of 22 %. Gross total resection was achieved in 80 % of cases under electrophysiological monitoring. After a median follow-up of 31.5 months, 70 % of patients maintained their preoperative modified McCormick scores, while 30 % showed deterioration.
CONCLUSION: Conservative management provides a temporary option, but tumor progression is inevitable. Delayed surgery may risk worse outcomes, making timely intervention advisable for patients with tumor growth, syrinx formation, or worsening neurological symptoms.
METHODS: A retrospective analysis of 315 patients diagnosed between 2018 and 2023 identified 10 meeting the inclusion criteria (mean age: 51 years, range: 37-63). Three were asymptomatic, and seven had mild symptoms such as pain or numbness. The mean maximum tumor diameter on sagittal MRI was 23.5 mm. Tumor progression and symptom changes were monitored, with surgery performed as needed.
RESULTS: Over a median conservative period of 36 months, all patients eventually required surgery due to symptom progression or tumor growth, with an average tumor size increase of 22 %. Gross total resection was achieved in 80 % of cases under electrophysiological monitoring. After a median follow-up of 31.5 months, 70 % of patients maintained their preoperative modified McCormick scores, while 30 % showed deterioration.
CONCLUSION: Conservative management provides a temporary option, but tumor progression is inevitable. Delayed surgery may risk worse outcomes, making timely intervention advisable for patients with tumor growth, syrinx formation, or worsening neurological symptoms.