Results: In the early phase after surgery, 71% and 43% of the participants were nonindependent ambulators at 1W and 2W, respectively. Histopathology indicated that patients with solid tumors (ependymoma, astrocytoma, or lipoma) showed significantly lower indices at 1W and 2W than those with vascular tumors (hemangioblastoma or cavernous hemangioma). Regarding tumor location, thoracic cases exhibited poorer lower-limb function at 1W and 2W and poorer walking ability at 2W than cervical cases. According to the receiver operating characteristic (ROC) analysis, 2 WISCI II points at 2W had the highest sensitivity (100%) and specificity (92.2%) in predicting the level of walking independence at 1 year postoperatively (the area under the ROC curve was 0.99 (95% confidence interval, 0.93–1.00). Conclusions The higher the lower-limb function scores in the early phase, the better the improvement in walking ability is predicted 1 year after ISCT resection.

Methods: Eighty patients who underwent surgical resection at Keio University and Fujita Health University in Tokyo, Japan between 2003 and 2015 with more than 2 years of follow-up were enrolled. A good surgical result was defined as an improvement in the modified McCormick Scale score by one grade or more or having the same clinical grade as was observed preoperatively. Meanwhile, a poor result was defined as a reduction in the McCormick Scale score of one grade or more or remaining in grade IV or V at final follow-up. Univariate and multivariate logistic regression analyses of the following factors were performed in the two groups: sex, age, preoperative Visual Analog Scale (VAS), tumor location, the extent of tumor resection, hemosiderin caps, cavity length, and tumor length on magnetic resonance imaging. Results: At final follow-up, 15 patients were included in the poor results group and 65 in the good results group. In the univariate analysis, the factors related to poor results were as follows: higher age, preoperative McCormick Scale score severity, higher preoperative VAS, thoracic location, hemosiderin capped, and non-gross total resection (GTR). A multiple logistic regression analysis was conducted and showed that age, worse preoperative McCormick Scale score, and non-GTR were significant factors for poor prognosis. Conclusions The independent risk factors for motor deterioration after ependymoma resection were age, worse preoperative McCormick Scale score, and non-GTR. Early surgery for patients with even mild neurological disorders could facilitate functional outcomes. These results may contribute to determining the optimal timing of surgery for spinal intramedullary ependymoma.

[Objective] Instructional videos on five of the 17 acupuncture techniques (hereinafter referred to as "techniques") were created, and a questionnaire was distributed among acupuncture and moxibustion college teachers to evaluate the utility of the educational materials.[Methods] The sparrow pecking technique (straight and oblique stabbing), gyration, rotation and twisting techniques, as well as vibration stimulation, were performed and the hand was simultaneously imaged with a diagnostic ultrasound device and filmed with a video camera. The questionnaire and a QR code for viewing the videos were sent to training schools by mail. The questionnaire included open-ended and multiple-choice questions regarding the teaching status of the techniques, changes in perception of the techniques after viewing the video, and the value of using the video as a teaching tool.[Results] Responses were received from nine schools (14 teachers). Each technique was taught only once at five of the schools. For all the techniques featured in the videos, not all the respondents answered that the subcutaneous and muscular tissue movements were consistent with their perceptions. Meanwhile, only 35.7% of the respondents had perceptions that were congruent with the video on vibratory stimulation. According to 78.6% of the respondents, instructional videos on these techniques were deemed to be necessary.[Discussion and Conclusion] The minimal repetition on the education of acupuncture and moxibustion techniques implies a lack of emphasis regarding these skills. The dissonance between the subcutaneous and muscular tissue movements that were familiar to the instructors and those discussed in the video highlighted the significant differences in skills training among the various training institutions. Based on this feedback, instructional videos can be considered essential in accurately teaching acupuncture and moxibustion techniques by providing visual aids.