Introduction: Spinal meningiomas are common benign, slow-growing tumors. They account for 25-45% of all intradural spinal tumors and about 12% of all meningiomas. Though few studies have discussed the factors predicting recurrence, a composite study of multiple clinic-radiological factors predicting the recurrence and functional outcome in a cohort of long follow-up is relatively scarce. In this study authors aim to study the factors predicting functional outcome and recurrence.
Methods: In this retrospective study, we reviewed clinico-radiological parameters of all patients who underwent surgery for spinal meningiomas in our institution between 1999- 2014. The demographic parameters such as age, sex, race and association with NF 2 were considered. The radiological parameters such as tumor size (in comparison to spinal canal), T2 signal changes of cord, spinal level (cervical/ dorsal/ cervicodorsal/ lumbosacral), no of level, location of tumor attachment (ventral/ lateral/ dorsal), shape (dumbbell/ enplaque) and presence of dural tail/ calcification were noted. The resection rate was classified according to Simpson’s grading. The functional status was analyzed utilizing modified McCormick functional scheme before surgery and at one year follow-up.
Results: Thirty eight patients (7 males and 31 females) with median age of 56 years (12-92 years) were included in this study. The mean follow-up was 6.8 years (1-12 years). On univariate analysis tumors expanding 2 or more levels (p=0.049), with ventral attachment (0.009) and occupying =75% of canal (both in transverse and antero-posterior diameter; p=0.02) were less likely to improve to Mac Cormick grade 1-3 at one year follow-up. On multivariate analysis, tumor with ventral attachment was found to be the only factor associated with poor- improvement.
On the other hand male sex (p=0.001) and presence of dural tail (p=0.049) were found to be associated with increased risk of recurrence in univariate analysis.
Conclusions: Spinal meningiomas with ventral attachment had worse functional outcome. Tumors with dural tail in male patients had more recurrence than their counterparts.
Patient Care: Analysis of clinico-radiological factors will help to predict the functional outcome and recurrence in spinal meningiomas.
Learning Objectives: 1. a composite study of multiple clinic-radiological factors predicting the recurrence and functional outcome in a cohort of long follow-up is relatively scarce for spinal meningiomas
2. Spinal meningiomas with ventral attachment had worse functional outcome
3. Spinal meningiomas with dural tail in male patients had more recurrence than their counterparts.
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2. Postalci L, Tugcu B, Gungor A, Guclu G: Spinal meningiomas: recurrence in ventrally located individuals on long-term follow-up; a review of 46 operated cases. Turk Neurosurg 21:449-453, 2011
3. Sandalcioglu IE, Hunold A, Muller O, Bassiouni H, Stolke D, Asgari S: Spinal meningiomas: critical review of 131 surgically treated patients. Eur Spine J 17:1035-1041, 2008