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Spinal meningiomas –  92 patients operated at our department


Authors: R. Voldřich;  D. Netuka;  V. Beneš
Authors‘ workplace: Neurochirurgická a neuroonkologická klinika 1. LF UK a ÚVN Praha
Published in: Cesk Slov Neurol N 2019; 82(6): 664-669
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2019664

Overview

Aim: Spinal meningiomas are the most com­mon primary spinal tumors. Our retrospective study describes the results of surgical treatment and compares them to foreign series. At the same time, it gives a brief overview of selected literature.

Materials and methods: The study includes 92 patients operated between years 1998 and 2018. Clinical symp­tomatology, age, gender, risk co-morbidities, spinal level, duration of symp­toms, radicality of resection, tumor recur­rences and complications as­sociated with treatment were evaluated.

Results: We encountered the dia­gnosis more often in women (81.5%). The average age was 64 years. Most meningiomas were located in the thoracic spine (79%), and the rest (21%) in the cervical spine. The most com­mon symp­tom was motor deficit dia­gnosed in 79% of cases. Sensation disorder (70%), sphincter dysfunction (10%) or local pain (4.3%) as a major symp­tom were less com­mon. Altogether 11% of the tumors were asymp­tomatic. The mean duration of symp­toms was 10 months. 92.3% of patients underwent radical resection. The mean fol­low-up was 36 months. Dur­­ing this period, we recorded tumor recur­rence in 8.7% of operated patients. 88% of symp­tomatic patients improved postoperatively, and 2% worsened. The rest remained clinical­ly unchanged.

Conclusion: The results of surgical treatment of spinal meningiomas are favorable. Although the rate of tumor recur­rence is low, regular and long-term fol­low-up of patients is es­sential for its early dia­gnosis.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


92例脊髓脑膜瘤在我科手术

目的:脊柱脑膜瘤是最常见的原发性脊柱肿瘤。我们的回顾性研究描述了手术治疗的结果,并将其与国外系列比较。同时,对所选文献进行简要概述。

材料和方法:该研究包括1998年至2018年期间接受手术的92例患者。评估了临床症状,年龄,性别,危险合并症,脊柱水平,症状持续时间,切除的彻底性,肿瘤复发和与治疗相关的并发症。

结果:我们在女性中更常遇到诊断(81.5%)。平均年龄为64岁。大多数脑膜瘤位于胸椎(79%),其余(21%)位于颈椎。最常见的症状是在79%的病例中诊断出运动不足。主要症状是感觉障碍(70%),以括约肌功能障碍(10%)或局部疼痛(4.3%)为主要症状者较少见。共有11%的肿瘤无症状。症状的平均持续时间为10个月。 92.3%的患者接受了根治性切除。平均随访时间为36个月。在此期间,我们记录了8.7%的手术患者肿瘤复发。 88%的有症状患者术后改善,2%恶化。其余的在临床上保持不变。

结论:脊柱脑膜瘤的手术治疗效果良好。尽管肿瘤的复发率很低,但是对患者的定期和长期随访对其早期诊断至关重要。

关键词:脑膜瘤–脊髓性脑膜瘤–手术治疗

Keywords:

operative treatment – Meningioma – spinal meningioma


Sources

1. Solero CL, Fornari M, Giombini S et al. Spinal meningiomas: review of 174 operated cases. Neurosurgery 1989; 25(2): 153– 160.

2. Levy WJ, Bay J, Dohn D. Spinal cord meningioma. J Neurosurg 1982; 57(6): 804– 812. doi: 10.3171/ jns.1982.57.6.0804.

3. Hua L, Zhu H, Deng J et al. Clinical and prognostic features of spinal meningioma: a thorough analysis from a single neurosurgical center. J Neurooncol 2018; 140(3): 639– 647. doi: 10.1007/ s11060-018-2993-3.

4. Duong LM, McCarthy BJ, McLendon RE et al. Descriptive epidemiology of malignant and nonmalignant primary spinal cord, spinal meninges, and cauda equina tumors, United States, 2004– 2007. Cancer 2012; 118(17): 4220– 4227. doi: 10.1002/ cncr.27390.

5. Helseth A, Mork SJ. Primary intraspinal neoplasms in Norway, 1955 to 1986. A population-based survey of 467 patients. J Neurosurg 1989; 71(6): 842– 845. doi: 10.3171/ jns.1989.71.6.0842.

6. Kshettry VR, Hsieh JK, Ostrom QT et al. Descriptive epidemiology of spinal meningiomas in the United States. Spine (Phila Pa 1976) 2015; 40(15): E886– E889. doi: 10.1097/ BRS.0000000000000974.

7. Westwick HJ, Yuh SJ, Shamji MF. Complication avoidance in the resection of spinal meningiomas. World Neurosurg 2015; 83(4): 627– 634. doi: 10.1016/ Jwneu.2014.12.015.

8. Gilard V, Goia A, Fer­racci FX et al. Spinal meningioma and factors predictive of post-operative deterioration. J Neurooncol 2018; 140(1): 49– 54. doi: 10.1007/ s11060-018-2929-y.

9. Westwick HJ, Shamji MF. Ef­fects of sex on the incidence and prognosis of spinal meningiomas: a surveil­lance, epidemiology, and end results study. J Neurosurg Spine 2015; 23(3): 368– 373. doi: 10.3171/ 2014.12.SPINE14974.

10. Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol 2010; 99(3): 307– 314. doi: 10.1007/ s11060-010-0386-3.

11. Wigertz A, Lonn S, Mathiesen T et al. Original contribution risk of brain tumors as­sociated with exposure to exogenous female sex hormones. Am J Epidemiol 2006; 164(7): 629– 636. doi: 10.1093/ aje/ kwj254.

12. Bayoumi AB, Laviv Y, Yokus B et al. Proposal of a new radiological clas­sification system for spinal meningiomas as a descriptive tool and surgical guide. Clin Neurol Neurosurg 2017; 162: 118– 126. doi: 10.1016/ j.clineuro.2017.10.001.

13. McCormick PC, Tor­res R, Post KD et al. Intramedul­lary ependymoma of the spinal cord. J Neurosurg 1990; 72: 523– 532. doi: 10.3171/ jns.1990.72.4.0523.

14. Simpson D. The recur­rence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 1957; 20(1): 22– 39. doi: 10.1136/ jn­np.20.1.22.

15. Moják P, Filip M, Linzer P et al. Intradurálne extramedulárne nádory chrbtice. Cesk Slov Neurol N 2019; 82/ 115(2): 125– 140. doi: 10.14735/ amcsn­n2019125.

16. Namer IJ, Pamir MN, Benli K et al. Spinal meningiomas. Neurochirurgia (Stuttg) 1987; 30(1): 11– 15. doi: 10.1055/ s-2008-1053647.

17. Maiti TK, Guthikonda B, Patra DP et al. Spinal meningiomas: clinicoradiological factors predict­­ing recur­rence and functional outcome. Neurosurg Focus 2016; 41(2): E6. doi: 10.3171/ 2016.5.FOCUS16163.

18. Gezen F, Kahraman S, Çanakci Z et al. Review of 36 cases of spinal cord meningioma. Spine (Phila Pa 1976) 2000; 25(6): 727– 731. doi: 10.1097/ 00007632-200003150-00013.

19. Roux FX, Nataf F, Pinaudeau M et al. Intraspinal meningiomas: review of 54 cases with discus­sion of poor prognosis factors and modern therapeutic management. Surg Neurol 1996; 46(5): 458– 464. doi: 10.1016/ s0090-3019(96)00199-1.

20. Klekamp J, Samii M. Surgical results for spinal meningiomas. Surg Neurol 1999; 52(6): 552– 562. doi: 10.1016/ s0090-3019(99)00153-6.

21. Ravindra VM, Schmidt MH. Management of spinal meningiomas. Neurosurg Clin N Am 2016; 27(2): 195– 205. doi: 10.1016/ j.nec.2015.11.010.

22. Gottfried ON, Gluf W, Quinones-Hinojosa A et al. Spinal meningiomas: surgical management and outcome. Neurosurg Focus 2003; 14(6): e2.

23. Nakamura M, Toyama Y, Chiba K et al. Long-term surgical outcomes of spinal meningiomas. Spine (Phila Pa 1976) 2012; 37(10): E617– E623. doi: 10.1097/ BRS.0b013e31824167f1.

24. Sandalcioglu IE, Bas­siouni H, Mül­ler O et al. Spinal meningiomas: critical review of 131 surgical­ly treated patients. Eur Spine J 2008; 17(8): 1035– 1041. doi: 10.1007/ s00586-008-0685-y.

25. K­­ing AT, Sharr MM, Gul­lan RW et al. Spinal meningiomas: a 20-year review. Br J Neurosurg 1998; 12(6): 521– 526. doi: 10.1080/ 02688699844367.

26. Setzer M, Vatter H, Vrionis FD et al. Management of spinal meningiomas: surgical results and a review of the literature. Neurosurg Focus 2007; 23(4): E14. doi: 10.3171/ FOC-07/ 10/ E14.

27. Cohen-Gadol AA, Zikel OM, Koch CA et al. Spinal meningiomas in patients younger than 50 years of age: a 21-year experience. J Neurosurg 2003; 98 (Suppl 3): 258– 263. doi: 10.3171/ spi.2003.98.3.0258.

28. Yamamuro K, Seichi A, Kimura A et al. Histological Investigation of resected dura mater. Spine (Phila Pa 1976) 2012; 37(22): E1398– E1401. doi: 10.1097/ BRS.0b013e318268c419.

29. Sachdev S, Soltys SG, Tupper L et al. Stereotactic radiosurgery yields long-term control for benign intradural, extramedul­lary spinal tumors. Neurosurgery 2011; 69(3): 533– 539. doi: 10.1227/ NEU.0b013e318218db23.

30. Dodd RL, Ryu MR, Kamnerdsupaphon P et al. CyberKnife radiosurgery for benign intradural extramedul­lary spinal tumors. Neurosurgery 2006; 58(4): 674– 685. doi: 10.1227/ 01.NEU.0000204128.84742.8F.

31. Bar­resi V, Caf­fo M, Tuccari G. Clas­sification of human meningiomas: lights, shadows, and future perspectives. J Neurosci Res 2016; 94(12): 1604– 1612. doi: 10.1002/ jnr.23801.

32. Schal­ler B. Spinal meningioma: relationship between histological subtypes and surgical outcome? J Neurooncol 2005; 75(2): 157– 161. doi: 10.1007/ s11060-005-1469-4.

33. Yoon SH, Chung CK, Jahng TA. Surgical outcome of spinal canal meningiomas. J Korean Neurosurg Soc 2008; 42(4): 300– 304. doi: 10.3340/ jkns.2007.42.4.300.

34. Postalci L, Tugcu B, Gungor A et al. Spinal meningiomas: recur­rence in ventral­ly located individuals on long-term fol­low-up; a review of 46 operated cases. Turk Neurosurg 2011; 21(4): 449– 453. doi: 10.5137/ 1019-5149.JTN .3518-10.2.

35. Peker S, Cerci A, Ozgen S et al. Spinal meningiomas: evaluation of 41 patients. J Neurosurg Sci 2005; 49(1): 7– 11.

36. Mirimanoff RO, Dosoretz DE, Linggood RM et al. Meningioma: analysis of recur­rence and progres­sion fol­low­­ing neurosurgical resection. J Neurosurg 1985; 62(1): 18– 24. doi: 10.3171/ jns.1985.62.1.0018.

37. Boström A, Bürgel U, Reinacher P et al. A less invasive surgical concept for the resection of spinal meningiomas. Acta Neurochir (Wien) 2008; 150(6): 551– 556. doi: 10.1007/ s00701-008-1514-0.

38. Riad H, Knafo S, Segnarbieux F et al. Spinal meningiomas: surgical outcome and literature review. Neurochirurgie 2013; 59(1): 30– 34. doi: 10.1016/ j.neuchi.2012.10.137.

39. Cush­­ing H, Eisenhardt L. Meningiomas. Their clas­sification, regional behaviour, life history, and surgical end results. Bull Med Libr As­soc 1938; 27(2): 185. 

Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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