Microsurgical resection of an ependymoma at the L1/L2 level adjacent to the conus medullaris.
Case description:The patient presented with progressive low back pain and radiating pain in the lower limbs. MRI of the thoracolumbar spine revealed a well-demarcated intramedullary lesion at the L1/L2 level, adjacent to the conus medullaris, showing intense contrast enhancement after gadolinium administration - features consistent with ependymoma.The procedure was performed via a left-sided posterolateral approach with resection of the left L1/L2 facet joint. After exposure of the spinal canal and dural opening under the operating microscope, a yellow-pink, well-defined tumor was identified and microsurgically resected in total, with preservation of the surrounding neural structures of the conus medullaris.To restore spinal stability after joint resection, instrumentation with carbon fiber pedicle screws was performed.
Postoperative course: Uneventful. The patient was discharged home on the third postoperative day in good general condition, without any neurological deficits. Neurosurgen: Piotr Makarewicz.
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