Return to work and clinical outcome after surgical treatment and conservative management of patients with intramedullary spinal cord ependymoma

The ability to return to work after treatment of diseases is an important issue. Aim of this study is to compare surgery and conservative management focusing on clinical outcome and ability to return to work in patients with intramedullary spinal cord ependymoma. Retrospective, single center study. The neurological status at first presentation, as well as in long-term follow-up, were assessed using the modified McCormick Disability Scale and modified Rankin Scale. The study population consisted of 56 patients, 23 (41%) were managed conservatively and 33 (59%) underwent microsurgical resection. The median age was 47.5 years in the conservative group and 44.5 in the surgical group. At first admission 18 of conservatively treated and 28 of surgically treated patients were employed, p = 0.7. At the last follow-up 15 (83%) of conservatively and 10 (36%) of surgically treated patients returned to work, p = 0.002. The median modified McCormick score in both groups (conservative vs. surgical) was at admission 1 vs. 1, p = 1.0 and at last follow up 1 vs. 2.5, p = 0.001. Patients clinical outcome in the surgical group was significantly reduced at last follow up as assessed by the modified Rankin Scale (mRs score of 0-2) at admission 100% vs. 100% and last follow-up 94% vs. 57%, p = 0.007. In our investigated study population, conservatively managed patients revealed a significantly better outcome and were more often able to return to work.