Acta Neurochirurgica

, Volume 154, Issue 10, pp 1815–1820 | Cite as

Cauda equina tumor surgery: how I do it

  • Enrico TessitoreEmail author
  • Ivan Cabrilo
  • Colette Boex
  • Karl Schaller
How I Do it



Tumors of the cauda equina usually require surgery due to their impingement on neighboring nerve roots, often resulting in pain and neurological deficits.


The Authors first give a brief introduction on cauda equina tumors, followed by a description of the surgical anatomy, and then develop the microsurgical technique. In particular, tricks to avoid complications are presented, underlining the importance of intraoperative neuromonitoring.


Both microsurgical technique and neuromonitoring are important in cauda equina tumor surgery, the goal of which is to achieve complete resection while at the same time preserving neurological function.


Cauda equina Tumor Microsurgical techniques Neuromonitoring 


Conflicts of interest


Supplementary material


The Authors show the surgical video concerning the resection of cauda equina ependymoma in a 65 year old man, suffering from left-sided L4 cruralgia for many months. Cranial is on the left, caudal is to the right. The patient’s right side is on the top of the image. (WMV 177796 kb)


  1. 1.
    Asazuma T, Toyama Y, Suzuki N, Fujimura Y, Hirabayshi K (1999) Ependymomas of the spinal cord and cauda equina: An analysis of 26 cases and a review of the literature. Spinal Cord 37:753–759PubMedCrossRefGoogle Scholar
  2. 2.
    Avci E, Kocaogullar Y, Fossett D (2002) Vertebral Column Anatomy. In: Fossett DT, Caputy AJ (eds) Operative Neurosurgical Anatomy. New York Stuttgart, Thieme, pp 121–126Google Scholar
  3. 3.
    Bogduk N (1980) A reappraisal of the anatomy of the human lumbar Erector Spinae. J Anat 131:525–540PubMedGoogle Scholar
  4. 4.
    Boström A, von Lehe M, Hartmann W, Pietsch T, Feuss M, Boström JP, Schramm J, Simon M (2011) Surgery for Spinal Cord Ependymomas: Outcome and Prognostic Factors. Neurosurgery 68:302–309PubMedCrossRefGoogle Scholar
  5. 5.
    Engelhard Herbert H, Lee VJ, Porter Kimberly R, Stewart Andrew K, Barua M, Barker Fred G II, Newton Herbert B (2010) Clinical presentation, histology, and treatment in 430 patients with primary tumors of the spinal cord, spinal meninges, or cauda equina. J Neurosurg Spine 13:67–77PubMedCrossRefGoogle Scholar
  6. 6.
    Hénaux P-L, Zemmoura I, Riffaud L, François P, Hamlat A, Brassier G, Morandi X (2011) Surgical treatment of rare cauda equina tumours. Acta Neurochir (Wien) 153:1787–1796CrossRefGoogle Scholar
  7. 7.
    Kucia EJ, Maughan PH, Kakarla UK, Bambakidis NC, Spetzler RF (2011) Surgical Technique and Outcomes in the Treatment of Spinal Cord Ependymomas: Part II: Myxopapillary Ependymoma. Neurosurgery 68(1 Suppl Operative):90–94PubMedGoogle Scholar
  8. 8.
    Traul DE, Shaffrey ME, Schiff D (2007) Part I: Spinal-cord neoplasms – intradural neoplasms. Lancet Oncology 8:35–45PubMedCrossRefGoogle Scholar
  9. 9.
    Van Goethem JWM, van den Hauwe L, Özsarlak Ö, De Schepper AMA, Parizel PM (2004) Spinal tumors. Eur J Radiol 50:159–176PubMedCrossRefGoogle Scholar
  10. 10.
    Wippold Franz J II, Smirniotopoulos James G, Pilgrim Thomas K (1997) Lesions of the cauda equina: a clinical and pathology review from the Armed Forces Institute of Pathology. Clin Neurol Neurosurg 99:229–234CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Enrico Tessitore
    • 1
    • 3
    Email author
  • Ivan Cabrilo
    • 1
  • Colette Boex
    • 2
  • Karl Schaller
    • 1
  1. 1.Neurosurgery Division, Department of Clinical Neurosciences, Faculty of MedicineGeneva University Medical CenterGenevaSwitzerland
  2. 2.Neurology Division, Department of Clinical Neurosciences, Faculty of MedicineGeneva University Medical CenterGenevaSwitzerland
  3. 3.Geneva University HospitalGenève 14Switzerland

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