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  • Spinal Meningiomas: Clinicoradiological Factors Predicting Functional Outcome and Recurrence

    Final Number:
    1601

    Authors:
    Tanmoy Kumar Maiti Mch; Shyamal C Bir MD PhD; Devi Prasad Patra MS M.CH. M.D. MRCS; Anil Nanda MD FACS

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    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.

    References: 1. Nakamura M, Tsuji O, Fujiyoshi K, Hosogane N, Watanabe K, Tsuji T, et al: Long-term surgical outcomes of spinal meningiomas. Spine (Phila Pa 1976) 37:E617-623, 2012 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

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