Ependymoma of the Spinal Cord and the Cauda Equina Region

Ependymomas are the most common glial tumors of the spinal cord, including the conus medullaris, filum terminale, and cauda equina. This study involved eight ependymomas of the spinal cord encountered during a 29-year period (1968-1996). The male:female ratio was 1:1.7, and the mean age at diagnosis was 33.7 years (range, 13-55 years). The outcome was studied in relation to initial presentation, initial therapy, location of tumor, histology of tumor, and gender after a follow-up period ranging from 2-16 years (mean, 113 months). Complete removal was achieved in six patients. Two patients received postoperative irradiation after partial removal. Histological examination revealed a benign ependymoma in all patients. Patients undergoing gross total excision at initial operation had excellent or good outcomes. We conclude that ependymomas of the spinal cord should be removed completely, if possible. Spine surgeons should be aware of the disease, and magnetic resonance imaging should be used in its detection.