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Updated: Sep 8, 2025
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
The role of MRI patterns in predicting neurologic deficits in spinal ependymomas
Caner Sarıkaya1, Cumhur Kaan Yaltırık2, Eyüp Varol3
1Department of Neurosurgery, Maltepe University Hospital, İstanbul, Turkey. canersk@gmail.com.
Objective:
Spinal ependymomas are the most common intramedullary spinal cord tumors, with surgical resection being the primary treatment modality. This study aimed to evaluate the prognostic value of preoperative MRI features in predicting motor deficits in patients undergoing surgery for spinal ependymomas.
Methods:
We retrospectively analyzed 71 patients with histopathologically confirmed spinal ependymomas who underwent surgical resection between 2009 and 2021. Preoperative MRI features-including tumor volume, cystic components, syrinx formation, intratumoral hemorrhage, and longitudinal tumor extension-were assessed. Motor strength was recorded pre- and postoperatively. Statistical analysis included univariate comparisons and multivariate logistic regression to identify independent predictors of neurological deficits.
Results:
Preoperative motor weakness was significantly associated with syrinx formation (p = 0.012), intratumoral hemorrhage (p = 0.015), and greater tumor length (p = 0.037). Postoperative motor deterioration was significantly correlated with intratumoral hemorrhage (p = 0.025), increased tumor volume (p = 0.007), and longitudinal extension (p = 0.001). In multivariate analysis, the number of vertebral levels involved was the only independent predictor of postoperative motor weakness (OR = 1.737; 95% CI: 1.063-2.838; p = 0.028). No independent predictors were identified for preoperative weakness, although syrinx formation showed a trend toward significance.
Conclusion:
Preoperative MRI findings-particularly intratumoral hemorrhage, syrinx formation, and longitudinal extension-are associated with motor deficits in spinal ependymomas. However, only longitudinal tumor extension was an independent predictor of postoperative neurological deterioration. These findings highlight the importance of comprehensive radiological assessment in preoperative planning and risk stratification. Small sample size and short-term postoperative assessment represent important limitations of this study.
Insights
Preoperative MRI features like hemorrhage and syrinx formation correlate with motor deficits in spinal ependymomas. Longitudinal tumor extension is the key predictor of postoperative weakness after surgery.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- Spinal ependymomas are the most common intramedullary spinal cord tumors.
- Surgical resection is the primary treatment for spinal ependymomas.
- Predicting neurological deficits is crucial for surgical planning and patient outcomes.
Purpose of the Study:
- To evaluate the prognostic value of preoperative MRI features.
- To identify predictors of motor deficits in patients with spinal ependymomas undergoing surgery.
Main Methods:
- Retrospective analysis of 71 patients with spinal ependymomas.
- Assessment of preoperative MRI features: tumor volume, cystic components, syrinx, hemorrhage, and longitudinal extension.
- Correlation of MRI findings with pre- and postoperative motor strength using statistical analysis.
Main Results:
- Preoperative motor weakness associated with syrinx, hemorrhage, and tumor length.
- Postoperative motor deterioration correlated with hemorrhage, tumor volume, and longitudinal extension.
- Longitudinal tumor extension (vertebral levels involved) was the sole independent predictor of postoperative motor weakness.
Conclusions:
- Preoperative MRI findings are associated with motor deficits in spinal ependymomas.
- Longitudinal tumor extension is a significant independent predictor of postoperative neurological deterioration.
- Comprehensive radiological assessment is vital for preoperative planning and risk stratification.
