Gliomas of the conus medullaris

Six patients with histologically verified gliomas of the conus medullaris (two astrocytomas, two ependymomas, two myxopapillary ependymomas) were diagnosed and studied. There were four men and two women ranging in age from 23 to 47 years. Predominant initial symptoms were back pain (four cases) and leg weakness (two cases). The most common findings on admission were flaccid paparesis with impaired sensation and bladder dysfunction. Postoperative MR images with more than 95% removal of a tumour were defined as 'subtotal removal' (noted in two of six cases), and less than 95% as 'partial removal' (four of six cases). All patients had postoperative radiotherapy, and the two patients with an astrocytoma underwent chemotherapy. During the follow up period ranging from 2 to 7 years, there was no tumour recurrence or regrowth on MR images except in a patient with a malignant astrocytoma, who indeed died from intracranial dissemination 2 years after surgery. Adjuvant therapy following the excision of a spinal glioma is also discussed.