LAUSR

OBJECTIVE Conus medullaris teratomas are extremely rare, and the current treatment experience is limited. The purpose of this study was to evaluate the clinical characteristics, radiological features, surgical outcomes and prognosis of the conus medullaris teratomas. METHODS We retrospectively reviewed 39 patients who received surgical resection for conus medullaris teratomas from January 2008 to December 2018, and all the operations were performed by one senior doctor. The clinical features, pre-/post-operative MRI findings, pathology, treatment strategies and outcomes were analyzed. Neurological status was evaluated by the modified JOA score. RESULTS Of the 39 patients, the mean age was 30.9 years. The male: female ratio was 20:19. The duration of symptoms ranged from 0.3 to 252 months (mean 61.6 months). Bladder and bowel dysfunction was the most common symptom (76.9%). Total resection was achieved in 25 patients (64.1%), subtotal resection in 11 (28.2%), and partial resection in 3 (7.7%). Mature teratoma was confirmed in all 39 patients. Neurological outcomes were improved 16 patients (45.7%), stable in 14 (40.0%), aggravated in 5 (14.3%) at a mean follow-up of 62.7 months. Recurrence was observed in 1 patient with subtotal resection. A second surgery with total resection was performed and the neurological symptom was stable during follow-up.results CONCLUSIONS: Total surgical resection is the optimal treatment strategy for patients with conus medullaris teratoma. Safe maximum tumor removal and residual tumor inactivation by electrocoagulation are recommended when total resection is not achieved. The surgical treatment provides a low rate of recurrence and an acceptable low complication rate. CONCLUSION