Spinal ependymoma resection causes difficulties in returning to work, sports

Despite being benign and causing only mild neurological impairments, spinal ependymoma makes it severely difficult for post-resection patients to return to their prior levels of professional and physical activities, a recent study has found.

Researchers conducted a retrospective, single-centre study of 65 patients (median age 45 years, 52.3 percent women) who underwent surgery for spinal ependymoma between 2009 and 2020. Outcomes included professional reintegration, physical activity, and quality of life (QoL), measured using tools such as the European Quality of Life 5 Dimensions (EQ-5D) and the Short-Form Health Questionnaire (SF-36).

Ten patients (15.4 percent) had focal lesions, while four (6.2 percent) eventually developed tumour recurrence. Tumours were intermedullary in 41.5 percent (n=27) and extramedullary in 58.5 percent (n=38) of cases.

EQ-5D utility surveys were performed a median of 5.4 years after surgery. Results showed that patients had a mean healthy utility score of 0.676, indicative of high disease burden and self-perceived disability. Pain emerged as the most restrictive factor for utility, and patient scores were the worst in this domain. Health-related QoL was not affected by age, but was significantly worse in women.

Similar patterns were found in the SF-36 tool, which revealed poor vitality (mean, 49.8 percent) and role limitations due to physical constraints (mean, 51.4 percent) in patients after resection.

Notably, the percentage of patients who were full-time employees dropped from 52.3 percent presurgery to 32.5 percent after the operation. Conversely, the proportion of participants who retired early jumped from 16.9 percent to 29.2 percent. Persistent pain, physical stress, and motor deficits were commonly cited reasons for difficulties to return to work.

Similarly, 66 percent of patients were engaged in individual sports before surgery, which dropped slightly to 63 percent after surgery. Participation in team sports decreased from 15 percent to 6 percent. Frequency of sports trainings likewise dropped after surgery.