Spinal subependymoma surgery: do no harm. Little may be more!

Area of Science:

• Neurosurgery
• Spinal Oncology
• Neuropathology

Background:

• Spinal subependymomas are rare tumors originating within the central spinal canal.
• These tumors often present as eccentric intramedullary masses.

Purpose of the Study:

• To review diagnostic and operative findings of spinal subependymomas.
• To evaluate surgical treatment outcomes and provide recommendations.

Main Methods:

• A systematic literature search was conducted on Ovid Medline, Embase, and PubMed Central databases.
• Articles were reviewed for cases of spinal subependymoma, focusing on perioperative management and outcomes.

Main Results:

• 105 cases were identified from 49 papers, with a recent increase in reported cases.
• Sensory symptoms (80%) were most common, followed by weakness (64%).
• Postoperative worsening of neurological function occurred in 51% of cases, even with complete resection (72% of worsened cases).

Conclusions:

• Complete resection was achieved in 65% of cases, but 57% experienced worsened function post-surgery.
• No malignant transformation was reported, suggesting good long-term survival.
• Surgical intervention should be approached with caution, especially in cases with minimal symptom progression.