Giuseppe Lanzino, M.D.1, Saul F. Morales-Valero, M.D.1, William E. Krauss, M.D.1, Mario Campero, M.D.2, and W. Richard Marsh, M.D.1
1Department of Neurologic Surgery, Mayo Clinic, Rochester Minnesota; 2Department of Neurology, Clinica Alemana-Universidad del Desarrollo, Santiago, Chile
Abstract: Intramedullary ependymomas are surgically curable tumors. However, their surgical resection poses several challenges. In this intraoperative video we illustrate the main steps for the surgical resection of a cervical intramedullary ependymoma. These critical steps include: adequate exposure of the entire length of the tumor; use of the intraoperative ultrasound; identification of the posterior median sulcus and separation of the posterior columns; Identification of the plane between the spinal cord and the tumor; mobilization and debulking of the tumor and disconnection of the vascular supply (usually from small anterior spinal artery branches). Following these basic steps a complete resection can be safely achieved in many cases.
Corresponding Author: Giuseppe Lanzino, M.D., Department of Neurologic Surgery, Mayo Clinic, 200 SW First Street, Rochester, MN 55905. Email: lanzino.giuseppe@mayo.edu.