Radiological analysis correlated with neurological outcomes following resection of myxopapillary ependymoma: patient series.

backgroundMyxopapillary ependymomas (MPEs) are rare intradural extramedullary tumors that often involve the conus and cauda equina. Current guidelines recommend resection as first-line management, but, despite a 92.4% overall 10-year survival rate, MPEs often have a high potential for postoperative morbidity with persisting or worsened neurological function. While several studies have identified potential radiological prognostic factors, none have specifically explored their relation to neurological outcomes. OBSERVATIONS: The authors retrospectively reviewed 16 MPE cases surgically treated within their institution between 2010 and 2021, evaluating preoperative/postoperative clinical data, surgical variables, and preoperative radiological features. Univariable analysis was performed using ANOVA for continuous variables and the chi-square test for categorical variables across neurological outcome groups. Multivariable modeling of neurological outcomes was done using logistic regression utilizing only radiological variables with a p value < 0.2. None of the radiological predictors reached statistical significance. The presence of preoperative weakness was the only significant predictor of a good neurological outcome within this model, while conus involvement was a significant predictor of urinary dysfunction at the final follow-up. LESSONS: Tumor size, conus involvement, and preoperative weakness are prognostic factors that may affect the morbidity profile of patients following resection. https://thejns.org/doi/10.3171/CASE25392.