Clinical Aspects of Spinal Meningiomas:a Review (original) (raw)
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Spinal meningiomas, from biology to management - A literature review
Frontiers in Oncology
Meningiomas arise from arachnoidal cap cells of the meninges, constituting the most common type of central nervous system tumors, and are considered benign tumors in most cases. Their incidence increases with age, and they mainly affect females, constituting 25-46% of primary spinal tumors. Spinal meningiomas could be detected incidentally or be unraveled by various neurological symptoms (e.g., back pain, sphincter dysfunction, sensorimotor deficits). The gold standard diagnostic modality for spinal meningiomas is Magnetic resonance imaging (MRI) which permits their classification into four categories based on their radiological appearance. According to the World Health Organization (WHO) classification, the majority of spinal meningiomas are grade 1. Nevertheless, they can be of higher grade (grades 2 and 3) with atypical or malignant histology and a more aggressive course. To date, surgery is the best treatment where the big majority of meningiomas can be cured. Advances in surgic...
Spinal meningiomas: surgical management and outcome
Neurosurgical FOCUS, 2003
Spinal meningiomas represent 25 to 46% of tumors of the spine. 9 Typically, they are located in the intradural extramedullary space, grow slowly, and spread laterally in the subarachnoid space until they induce symptoms. They most frequently occur in the thoracic region in middle-aged women. Patients typically present with pain, sensory loss, weakness, and sphincter disturbances. Advances in radiological and surgical assistive devices (MR imaging, neuromonitoring, intraoperative ultrasonography, operative microscope, and ultrasonic surgical aspirator) have resulted in earlier diagnosis and aided in obtaining a total resection. Prognosis in patients with spinal meningiomas is excellent, and even patients with a poor preoperative neurological status can respond favorably to surgery.
Review of 36 Cases of Spinal Cord Meningioma
Spine, 2000
Study Design. Thirty-six consecutive patients with histologically confirmed spinal cord meningioma were presented to evaluate clinical, diagnostic, therapeutic options and to correlate treatment methods and outcome.
Management of spinal meningiomas: surgical results and a review of the literature
Neurosurgical FOCUS, 2007
ENINGIOMAS are typically benign, slowly growing tumors. Despite the fact that their histogenesis is unclear, it is thought that arachnoidal cells are the most likely origin of these lesions. Meningiomas account for 13 to 19% of all intracranial tumors. Spinal meningiomas represent 12% of all meningiomas 31 and 25 to 45% of intradural spine tumors. 14 Spinal meningiomas lead to chronic spinal cord compression and myelopathy. Treatment is predominantly surgical. Previously published data indicate mostly favorable outcomes; however, progressive spinal cord compression due to a spinal meningioma can lead to neurological deterioration that, at times, can result in a permanent deficit even after successful surgery. In this article we review our experience at two neurosurgical centers with the surgical management of spinal me-ningiomas with particular attention given to surgical techniques, adjuvant therapies, prognostic factors, recurrence rates, and long-term outcomes. Furthermore, we reviewed the literature as it pertains to the surgical treatment of these tumors.
Spinal meningiomas: Management and outcomes
Journal of Pakistan Medical Association, 2023
Spinal meningiomas are relatively rare, benign, intradural, extramedullary tumours, that are typically slow-growing and well-defined. Surgery is always the first line for treating spinal meningiomas. Here, we have discussed the existing literature on spinal meningiomas and the role of surgery in determining the outcomes.
Turkish Neurosurgery, 2011
AIm: Surgical removal of spinal meningiomas is usually not difficult. In neurosurgical practice, their locations and growing patterns may affect surgical results. Ventrally located and en plaque meningiomas may not be removed totally. The aim of this study was to present the results of surgery in cases with spinal meningiomas, and reveal the factors affecting outcome. mAterIAl and methOds: There were 46 cases operated between January 1995 and December 2009 in single clinic. There were 33 female and 13 male patients. The mean age was 52. All patients underwent microsurgical resection using posterior approach. results: Total resection was obtained in 38 patients (82%). Twenty-eight (61%) patients experienced clinical improvement after surgery. The tumor was completely dorsal to the spinal cord in 30 cases, dorsolateral in nine and ventral to the spinal cord in seven cases. We experienced eight recurrences (17%). Recurrences were seen most commonly seen in ventrally located tumors (62%). COnClusIOn: Complete resection of spinal meningiomas seems to produce a good clinical outcome. Recently, advances in microneurosurgery and neuroimaging techniques have resulted in decreases in morbidity and recurrence rates in spinal meningiomas.
Surgical Treatment of Spinal Meningiomas
InTech eBooks, 2016
Spinal meningiomas are common spinal tumors; in most cases they are benign and with a good surgical prognosis. However, specific location, infiltration of spinal cord, vascular encasement, or spinal root involvement can bring to a less favorable prognosis. We reviewed a series of 173 consecutive patients with spinal meningiomas treated from 1976 to 2011 in our institution, and data were stratified according to sex, age, symptoms, axial location, Simpson resection grade, and functional pre-/postoperative status. Particular attention was paid to description of those factors leading to a poor outcome. Functional improvement at follow-up was observed in 86.7% of cases, 6.4% of patients resulted stable, and 6.9% worsened; a low functional grade before surgery was connected to a lesser improvement after. Anterolateral meningiomas were the most represented (42.2%); a gross total resection (Simpson grade I and II) was conducted in 98.8% and a macroscopically complete removal without dural resection or coagulation (Simpson grade III) was performed in 1.2%. According to data from our series, negative prognostic factors seem to be: anterior or anterolateral axial implant, longlasting symptoms before diagnosis, WHO grade > I, Simpson grade II and III resection, sphincter involvement, and worse functional grade at onset.
Spinal meningiomas: critical review of 131 surgically treated patients
European Spine Journal, 2008
This study was undertaken to analyze the functional outcome of surgically treated spinal meningiomas and to determine factors for surgical morbidity. Between January 1990 and December 2006 a total of 131 patients underwent surgical resection of a spinal menigioma. There were 114 (87%) female and 17 (13%) male patients. Age ranged from 17 to 88 years (mean 69 years). The mean follow-up period was 61 months (range 1-116 months) including a complete neurological examination and postoperative MRI studies. The pre-and postoperative neurological state was graded according to the Frankel Scale. Surgery was performed under standard microsurgical conditions with neurophysiological monitoring. In 73% the lesion was located in the thoracic region, in 16% in the cervical region, in 5% at the cervico-thoracic junction, in 4.5% at the thoraco-lumbar junction and in 1.5% in the lumbar region. Surgical resection was complete in 127 patients (97%) and incomplete in 4 patients (3%). At the last follow-up the neurological state was improved or unchanged in 126 patients (96.2%) and worse in 4 patients (3%). Permanent operative morbidity and mortality rates were 3 and 0.8%, respectively. Extensive tumour calcification proved to be a significant factor for surgical morbidity (P \ 0.0001). Radical resection of spinal meningiomas can be performed with good functional results. Extensive tumor calcification, especially in elderly patients proved to harbor an increased risk for surgical morbidity.