{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:07:15Z","timestamp":1776096435569,"version":"3.50.1"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,30]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to review the management and outcomes of a consecutive cohort of patients with spinal myxopapillary ependymoma (MPE) treated at the authors\u2019 institution over a 23-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective review of all patients treated surgically for spinal MPEs at a single institution between May 1998 and August 2021 was performed. Preoperative and postoperative clinical data, imaging, and\/or radiology reports were reviewed to identify patient presentation and outcomes as well as tumor size, location, CSF dissemination, and other features. Method and extent of resection were characterized and related to preoperative tumor characteristics and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Fifty-six patients underwent 60 index surgical procedures at a single institution, including 4 surgeries for resection of a solitary drop sacral metastasis. The median postoperative follow-up was 126 months (range 22\u2013304 months). En bloc gross-total resection (EGTR) was performed in 15 cases, marginal GTR (MGTR) in 17, piecemeal GTR (PGTR) in 6, piecemeal near-total resection (PNTR) in 9, and subtotal resection (STR) in 13 cases. Of the 55 primary filum terminale MPEs, 40 (73%) arose proximally, with their inferior tumor margin located at or above the L3 vertebral body. Nearly all patients who underwent EGTR (14\/15) or MGTR (17\/17) had MPEs that originated in the proximal filum terminale. In contrast, 10 of 13 patients who underwent STR had a distal MPE origin (below L3). CSF tumor dissemination, including drop metastases, was identified in 19.6% (11\/56) of patients. Tumor size, especially width, significantly influenced the method of complete resection: the mean width of tumors resected with EGTR was 1.0 cm (range 0.4\u20131.7 cm) while the mean width of MGTR tumors was 1.5 cm (range 1.0\u20132.2 cm) (p &lt; 0.001). Location, size, and marginal integrity of the tumor surface were important factors that influenced extent and quality of resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>MPEs are benign tumors that arise predominantly from the filum terminale. Resection can be curative, especially for well-marginated tumors arising from the proximal filum terminale. Despite their benign nature, the tumors\u2019 lack of a capsule, friable tumor consistency, and frequent direct contact with the CSF and cauda equina create a propensity for local recurrence and CSF dissemination, especially for larger and distally originating tumors. Thus, long-term follow-up is recommended for all patients as is early surgical intervention for small, incidental MPEs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.9.spine25650","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T16:09:59Z","timestamp":1770307799000},"page":"630-644","source":"Crossref","is-referenced-by-count":0,"title":["Surgical treatment of myxopapillary ependymoma: an institutional case series of 56 patients"],"prefix":"10.3171","volume":"44","author":[{"given":"Evan F.","family":"Joiner","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin A.","family":"Neira","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane E.","family":"Kostadinov","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phoebe L.","family":"Greenwald","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Washington, Seattle Children\u2019s Hospital, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander G.","family":"Khandji","sequence":"additional","affiliation":[{"name":"Radiology, Columbia University\/NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher E.","family":"Mandigo","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter D.","family":"Angevine","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul C.","family":"McCormick","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"9","key":"b1","series-title":"Acta Neurochir (Wien)","first-page":"2453","article-title":"The WHO 2021 Classification of Central Nervous System tumours: a practical update on what neurosurgeons need to know\u2014a minireview","volume":"164","author":"Torp SH","year":"2022","unstructured":"Torp SH, Solheim O, Skjulsvik AJ. The WHO 2021 Classification of Central Nervous System tumours: a practical update on what neurosurgeons need to know\u2014a minireview. Acta Neurochir (Wien). 2022;164(9):2453\u20132464."},{"issue":"1","key":"b2","series-title":"Brain Tumor Pathol","first-page":"25","article-title":"Primary myxopapillary ependymoma of the fourth ventricle with cartilaginous metaplasia: a case report and review of the literature","volume":"29","author":"Chakraborti S","year":"2012","unstructured":"Chakraborti S, Govindan A, Alapatt JP, Radhakrishnan M, Santosh V. Primary myxopapillary ependymoma of the fourth ventricle with cartilaginous metaplasia: a case report and review of the literature. Brain Tumor Pathol. 2012;29(1):25\u201330."},{"issue":"2 Suppl","key":"b3","series-title":"J Neurosurg","first-page":"322","article-title":"Intraspinal extradural myxopapillary ependymoma of the sacrum arising from the filum terminale externa","volume":"93","author":"Fourney DR","year":"2000","unstructured":"Fourney DR, Fuller GN, Gokaslan ZL. Intraspinal extradural myxopapillary ependymoma of the sacrum arising from the filum terminale externa. Case report. J Neurosurg. 2000;93(2 Suppl):322\u2013326."},{"issue":"4","key":"b4","series-title":"Cancer","first-page":"883","article-title":"Myxopapillary ependymoma. A clinicopathologic and immunocytochemical study of 77 cases","volume":"56","author":"Sonneland PR","year":"1985","unstructured":"Sonneland PR, Scheithauer BW, Onofrio BM. Myxopapillary ependymoma. A clinicopathologic and immunocytochemical study of 77 cases. 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