Journal of Neuro-Oncology

, Volume 135, Issue 1, pp 93–98 | Cite as

Natural history of intramedullary spinal cord ependymoma in patients preferring nonoperative treatment

  • Bedjan Behmanesh
  • Florian Gessler
  • Stephan Dützmann
  • Daniel Dubinski
  • Lioba Imoehl
  • Volker Seifert
  • Matthias Setzer
  • Gerhard Marquardt
Clinical Study


Surgical resection of intramedullary spinal cord ependymoma still remains the standard of care but is challenging and occasionally associated with poor outcome. The aim of this study is therefore to provide additional information regarding the natural history of conservatively treated symptomatic intramedullary spinal cord ependymoma. Retrospective, single center review of all patients with intramedullary spinal cord ependymoma treated conservatively (wait and see) between 1980 and 2016. The neurological outcomes at first presentation, as well as in long-term follow-up, were assessed using the modified McCormick Disability Scale and modified Rankin Scale. Thirteen of 41 patients were managed conservatively and were included in the study. Mean age at the admission was 49 years. There were seven women and six men. All patients were symptomatic at the time of presentation. The mean follow-up from admission to the last neurological examination was 47.9 months. The mean modified McCormick score in conservatively treated patients was 1.3 at admission and 1.6 (p = 0.3) at last follow-up. There was no significant neurological detoriation over time in conservatively managed patients as assessed by the modified Rankin Scale at first presentation and last follow-up (mRS scores of 0–2, 100 vs 92%; p = 0.9). This cohort of conservatively managed patients with symptomatic intramedullary spinal cord ependymoma was clinically stable throughout the follow-up period. Our data provide additional information for counseling patients with intramedullary spinal cord tumors who chose a nonoperative treatment.


Intramedullary spinal cord ependymoma Surgery Conservative therapy Neurological status Follow-up Outcome 



No funding supported this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of NeurosurgeryGoethe- UniversityFrankfurt am MainGermany
  2. 2.Department of NeurosurgeryUniversity Hospital, FrankfurtFrankfurtGermany

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