Long-term Neurologic Outcome After Spinal Ependymoma Resection With Multimodal Intraoperative Electrophysiological Recording: Cohort Study and Review of the Literature
Grégoire P. Chatain,
Michael W. Kortz,
Stephanie Serva,
Keshari Shrestha,
Patrick Hosokawa,
Timothy H. Ung,
Michael Finn
Affiliations
Grégoire P. Chatain
Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA
Michael W. Kortz
Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA
Stephanie Serva
Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA
Keshari Shrestha
Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA
Patrick Hosokawa
Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO, USA
Timothy H. Ung
Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA
Michael Finn
Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA
Objective To evaluate how multimodal intraoperative neuromonitoring (IONM) changes during spinal ependymoma (SE) resection correlate with long-term neuro-functional outcomes. Methods A retrospective analysis of patients aged 18 years or older who underwent surgical resection for SE over a 10-year period was conducted. IONM changes were defined as sustained transcranial motor evoked potential (TcMEP) and/or somatosensory evoked potential (SSEP) signal decrease of 50% or greater from baseline. Primary endpoints were postoperative modified McCormick Neurologic Scale (MNS) scores at postoperative day (POD) 50% below baseline (all p 50% below baseline, particularly for TcMEP, are significantly associated with higher MNS postoperatively out to 2 years. Intraoperative and postoperative management of these patients warrant special consideration to limit neurologic morbidity.
