Radiological analysis correlated with neurological outcomes following resection of myxopapillary ependymoma: patient...

Myxopapillary ependymomas (MPEs) are rare intradural extramedullary tumors that often involve the conus and cauda equina. Current guidelines recommend resection as first-line management, but, despite a 92.4% overall 10-year survival rate, MPEs often have a high potential for postoperative morbidity with persisting or worsened neurological function. While several studies have identified potential radiological prognostic factors, none have specifically explored their relation to neurological outcomes.

The authors retrospectively reviewed 16 MPE cases surgically treated within their institution between 2010 and 2021, evaluating preoperative/postoperative clinical data, surgical variables, and preoperative radiological features. Univariable analysis was performed using ANOVA for continuous variables and the chi-square test for categorical variables across neurological outcome groups. Multivariable modeling of neurological outcomes was done using logistic regression utilizing only radiological variables with a p value < 0.2. None of the radiological predictors reached statistical significance. The presence of preoperative weakness was the only significant predictor of a good neurological outcome within this model, while conus involvement was a significant predictor of urinary dysfunction at the final follow-up.

Tumor size, conus involvement, and preoperative weakness are prognostic factors that may affect the morbidity profile of patients following resection. https://thejns.org/doi/10.3171/CASE25392.