Intraoperative Ultrasound Imaging Features Guiding Surgical Strategy in Spinal Cord Ependymoma Resection

Area of Science:

• Neurosurgery
• Medical Imaging
• Oncology

Background:

• Preoperative imaging offers initial insights into spinal cord ependymoma infiltration and resection potential.
• Intraoperative decisions are crucial for successful tumor removal.
• This study focuses on intraoperative ultrasound (iUS) to guide surgical strategy.

Purpose of the Study:

• To characterize intraoperative ultrasound (iUS) features in spinal cord ependymomas.
• To identify iUS features associated with successful en-bloc resection.
• To guide real-time surgical strategy during ependymoma removal.

Main Methods:

• Retrospective review of iUS images during spinal cord ependymoma resection.
• Assessment of peritumoral halo, spinal cord area overlying tumor poles, tumor cysts, and spinal cord diameter.
• Collection of demographic, surgical, and neurological outcome data.

Main Results:

• All tumors showed a peritumoral halo; 57% underwent en-bloc resection.
• Intraoperative neurophysiological changes occurred in all patients.
• Postoperative neurological status remained stable compared to preoperative.

Conclusions:

• Intraoperative ultrasound (iUS) provides valuable features for preoperative surgical planning in spinal cord ependymomas.
• Further research is needed to confirm if peritumoral halo and spinal cord area predict outcomes.
• iUS aids in developing structured resection plans before spinal cord manipulation.