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Complications associated with the treatment for spinal ependymomas
Daniel T Nagasawa1, Zachary A Smith, Nicole Cremer
1Department of Neurological Surgery, University of California Los Angeles, CA 90095-1761, USA.
Neurosurgical Focus
|October 4, 2011
Summary
Spinal cord ependymomas, though rare, are increasingly treated with surgery. However, potential complications like neurological deficits and instability necessitate careful management and monitoring.
Area of Science:
- Neurosurgery
- Oncology
- Neuropathology
Background:
- Spinal cord ependymomas are rare central nervous system (CNS) neoplasms, accounting for approximately 5% of all CNS tumors and 15% of spinal cord tumors.
- Surgical resection has become the primary treatment for these lesions, evolving from a purely diagnostic role.
Purpose of the Study:
- To review the potential complications associated with the surgical treatment of spinal cord ependymomas.
- To highlight the importance of identifying and acknowledging these risks for improved patient outcomes.
Main Methods:
- Literature review of surgical outcomes for spinal cord ependymomas.
- Analysis of common and serious complications reported in the postoperative period.
- Discussion of the impact of technological advances and adjuvant therapies.
Main Results:
- Surgical treatment, despite advances, carries risks including neurological deficits (sensory loss, motor dysfunction, bowel/bladder issues), wound complications, and cerebrospinal fluid (CSF) leaks.
- Radiotherapy increases the risk of wound complications and CSF leaks, and may lead to radiation myelopathy.
- Postoperative spinal instability and deformities are noted, particularly in pediatric patients.
Conclusions:
- Despite improvements in microsurgical techniques and intraoperative monitoring, significant complications persist in spinal ependymoma treatment.
- Awareness and early detection of these potential problems are crucial for prevention and enhancing patients' quality of life.
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