Surgical results for spinal meningiomas

Area of Science:

• Neurosurgery
• Spinal Oncology
• Radiology

Background:

• Spinal meningiomas are tumors arising from the meninges of the spinal cord.
• Surgical resection is the primary treatment modality.
• Advances in diagnostic imaging, such as MRI, may impact diagnosis and outcomes.

Purpose of the Study:

• To evaluate the impact of magnetic resonance imaging (MRI) on the diagnosis and surgical outcomes of spinal meningiomas.
• To compare outcomes before and after the widespread adoption of MRI.
• To identify factors influencing surgical success and recurrence.

Main Methods:

• Retrospective analysis of 130 spinal meningioma surgeries performed between 1977 and 1998.
• Comparison of patient data from two periods: 1977-1987 (pre-MRI) and 1988-1998 (post-MRI).
• Assessment of diagnostic timelines, preoperative Karnofsky Scores, resection completeness, and postoperative neurological outcomes.

Main Results:

• The introduction of MRI significantly shortened the time to diagnosis by approximately 6 months.
• Preoperative Karnofsky Scores improved significantly in the MRI era, indicating better patient condition at surgery.
• Complete resection rates and overall postoperative neurological outcomes remained unchanged between the two periods.
• En plaque and recurrent meningiomas were associated with incomplete resection, worse long-term functional status, and higher recurrence rates.

Conclusions:

• Complete resection is crucial for favorable postoperative neurological outcomes in spinal meningioma patients.
• While MRI has improved diagnostic efficiency and preoperative patient status, it has not significantly altered surgical results.
• En plaque and recurrent spinal meningiomas present significant surgical challenges requiring specialized approaches to achieve complete resection and minimize recurrence.