Predictors of Long-Term Outcome and Recurrence of Intramedullary Spinal Ependymomas: A multicenter study.

Objectives: To define prognostic factors that affect clinical outcome of patients after surgical resection of spinal intramedullary ependymoma. Methods: A retrospective multi-center study, including all cases operated on from 2007 through 2024 at 3 institutes. Data on surgical factors included: resection extent, intraoperative neurophysiology monitoring methods, and intraoperative/postoperative complications. Results: A total of 19 patients were included with a mean age of 37.8 years (SD = 13.2, range 8-57 years). The majority of ependymomas (n = 14, 73.7%) were in the cervical region. The most common presenting symptoms included pain in 14 patients (73.7%), sensory deficits in 11 patients (57.8%), and motor deficits 10 patients (52.6%). As per preoperative McCormick grading, 31.6%, 10.5%, and 31.6% were grade I, II, and III, respectively. Postoperatively, 57.9% of patients improved to McCormick grade I. Total gross tumor resection was achieved in 15 participants (78.9%). Syndromes, specifically neurofibromatosis type II, were significantly associated with a chance of recurrence (p = 0.004) and the need for a second surgery (p = 0.018). Conclusion: The preoperative neurological status correlates significantly with the postoperative outcome of the patient.