Spinal ependymomas represent 13% of all medullary tumours. They are the most frequent tumours in the cauda equina, conus medullaris and at an intramedullary level.
The first clinical indications of intramedullary tumours is back pain, followed by the possible appearance of clinical deficits which, depending on the location of the lesion may affect the lower extremities (dorsal and lumbar ependymomas) or all four limbs (cervical ependymomas). Lumbar ependyomas may simulate a radicular profile, and sphincteric affectation may appear in up to 20% of cases.
Myxopapillary ependymomas (grade I, WHO) are of slow growth. In spite of their low aggressiveness, in certain cases they present dissemination along the neural axis and so a resonance of the entire neural, cranial, cervical, dorsal and lumbar axis is essential to discard tumoural implants.
The treatment of choice for these tumours is surgical and may be associated with radiotherapy in some cases such as when the cauda equina is involved.
Given the location of these lesions, we use resection equipment such as ultrasonic aspirators and intraoperative monitoring that enables minimising the manipulation of healthy tissue at the same time as controlling the function of neuronal tissue.