Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bret P, Lecuire J, Lapras C, Deruty R, Dechaume JP, Assaad A (1976) Intraspinal meningiomas. A series of 60 cases. Neurochirurgie 22:5–22
Cohen-Gadol AA, Zikel OM, Koch CA, Scheithauer BW, Krauss WE (2003) Spinal meningiomas in patients younger than 50 years of age: a 21-year experience. J Neurosurg 98:258–263
Frankel HL, Hancock DO, Hyslop G, Melzak J, Michaelis LS, Ungar GH, Vernon JD, Walsh JJ (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. I. Paraplegia 7:179–192
Gezen F, Kahraman S, Canakci Z, Beduk A (2000) Review of 36 cases of spinal cord meningioma. Spine 25:727–731
Gottfried ON, Gluf W, Quinones-Hinojosa A, Kan P, Schmidt MH (2003) Spinal meningiomas: surgical management and outcome. Neurosurg Focus 14:e2
King AT, Sharr MM, Gullan RW, Bartlett JR (1998) Spinal meningiomas: a 20-year review. Br J Neurosurg 12:521–526
Klekamp J, Samii M (1999) Surgical results for spinal meningiomas. Surg Neurol 52:552–562
Levy WJ Jr, Bay J, Dohn D (1982) Spinal cord meningioma. J Neurosurg 57:804–812
Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL (1985) Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg 62:18–24
Morandi X, Haegelen C, Riffaud L, Amlashi S, Adn M, Brassier G (2004) Results in the operative treatment of elderly patients with spinal meningiomas. Spine 29:2191–2194
Mulholland RC (1996) Sir William Gowers 1845–1915. Spine 21:1106–1110
Pena M, Galasko CS, Barrie JL (1992) Delay in diagnosis of intradural spinal tumors. Spine 17:1110–1116
Roux FX, Nataf F, Pinaudeau M, Borne G, Devaux B, Meder JF (1996) Intraspinal meningiomas: review of 54 cases with discussion of poor prognosis factors and modern therapeutic management. Surg Neurol 46:458–463; discussion 463–454
Sandalcioglu IE, Wiedemayer H, Secer S, Asgari S, Stolke D (2002) Surgical removal of brain stem cavernous malformations: surgical indications, technical considerations, and results. J Neurol Neurosurg Psychiatry 72:351–355
Schaller B (2005) Spinal meningioma: relationship between histological subtypes and surgical outcome? J Neurooncol 75:157–161
Schroth G, Thron A, Guhl L, Voigt K, Niendorf HP, Garces LR (1987) Magnetic resonance imaging of spinal meningiomas and neurinomas. Improvement of imaging by paramagnetic contrast enhancement. J Neurosurg 66:695–700
Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20:22–39
Solero CL, Fornari M, Giombini S, Lasio G, Oliveri G, Cimino C, Pluchino F (1989) Spinal meningiomas: review of 174 operated cases. Neurosurgery 25:153–160
Weil SM, Gewirtz RJ, Tew JM Jr (1990) Concurrent intradural and extradural meningiomas of the cervical spine. Neurosurgery 27:629–631
Wiedemayer H, Fauser B, Sandalcioglu IE, Schafer H, Stolke D (2002) The impact of neurophysiological intraoperative monitoring on surgical decisions: a critical analysis of 423 cases. J Neurosurg 96:255–262
Wiedemayer H, Sandalcioglu IE, Aalders M, Wiedemayer H, Floerke M, Stolke D (2004) Reconstruction of the laminar roof with miniplates for a posterior approach in intraspinal surgery: technical considerations and critical evaluation of follow-up results. Spine 29:E333–342
Wiedemayer H, Sandalcioglu IE, Armbruster W, Regel J, Schaefer H, Stolke D (2004) False negative findings in intraoperative SEP monitoring: analysis of 658 consecutive neurosurgical cases and review of published reports. J Neurol Neurosurg Psychiatry 75:280–286
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sandalcioglu, I.E., Hunold, A., Müller, O. et al. Spinal meningiomas: critical review of 131 surgically treated patients. Eur Spine J 17, 1035–1041 (2008). https://doi.org/10.1007/s00586-008-0685-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-008-0685-y