Surgical management of a huge intramedullary ependymoma from oblongata to T4
Bibliographic record
Abstract
INTRODUCTION AND IMPORTANCE: Huge intramedullary tumor is a rare condition. Surgical management of such huge ependymoma is technically challenging. We reported one case of 300 mm long intramedullary spinal cord ependymoma from oblongata to T4, which was satisfactorily en bloc gross total resected and the cervical spine alignment was successfully maintained by laminoplasty. CASE PRESENTATION: A 30-year-old man presented to our service with two-year progressive neck pain combined with bilateral sense disorders of both the upper and lower extremities. The neurological grade was ASIA D. Repeat MRI imaging demonstrated a "medulla oblongata to T4" intramedullary spinal cord tumor complicated with cervical physiological curvature loss. CLINICAL DISCUSSION: Laminectomies were made at the C1-T4 level by a milling cutter. The tumor was gently separated bilaterally. The ventral part of the tumor was separated from the cranial and the caudal ends until reaching the middle site of the tumor. The whole tumor was isolated en bloc. Titanium miniplates were used bilaterally to fix both sides of the laminoplasty section on each level. At the 2-year postoperative follow-up, the muscle strength of both the upper and lower limbs were grade Ⅳ. No tumor recurrence was detected. CONCLUSION: The total removal of an intramedullary ependymoma should be recommended as soon as the diagnosis is made, regardless of its extension. Long-level laminoplasty could be an effective alternative option to maintain the proper spine alignment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".