[Microsurgery of cervical intramedullary ependymomas extending into the medulla oblongata]

Intramedullary spinal cord ependymomas are well-demarcated tumors, which can be totally resected without significant morbidity. However, it is challenging to remove intramedullary ependymomas extending into the medulla oblongata, because the medulla oblongata has such important roles as regulation of respiration, circulation, and digestion. We describe here three cases of intramedullary ependymomas extending into the medulla oblongata. The tumors were localized in the dorsal part of the caudal medulla oblongata and were surrounded by the nuclei and tracts related to the dorsal columns. The tumors were safely exposed by dividing the medulla oblongata along the posterior median sulcus and resected from the surrounding normal tissues. Although patients demonstrated transient dorsal column dysfunction postoperatively, the symptom finally recovered.