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Review of 36 cases of spinal cord meningioma
F Gezen1, S Kahraman, Z Canakci
1Department of Neurosurgery, Gülhane Medical Faculty, Ankara, Turkey.
Study Design:
Thirty-six consecutive patients with histologically confirmed spinal cord meningioma were presented to evaluate clinical, diagnostic, therapeutic options and to correlate treatment methods and outcome.
Objective:
To present the incidence, clinical presentation, localization, techniques, and long term results of surgically treated spinal meningiomas.
Summary Of Background Data:
Meningiomas are common tumors of spinal neoplasm. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. However, spinal meningiomas may recur, especially as a result of incomplete resection.
Methods:
Thirty-six consecutive patients with histologically confirmed spinal meningiomas were treated from 1980 to 1997. Neuroradiological diagnosis was made through myelogram in 20 patients, CT scan in 15 patients, and MRI in 16 patients. All patients were operated on via the posterior approach and using microsurgical technique and when necessary Cooper-Ultrasonic surgical aspirator (CUSA) and CO2 laser were also applied. The patients were followed for 2 to 15 years (mean 9 years). Radiotherapy was not undertaken except in recurrent tumors.
Results:
The most frequent site of spinal meningiomas was in the thoracic region. In 30 (83%) patients tumors were found to be completely intradural extramedullary during surgery. Total tumor resection was achieved in 35 (97%) of patients. In the follow-up period, 30 cases (83%) improved when compared to their preoperative conditions. There was one operative mortality (3%). A 66-year-old women died of pulmonary emboli.
Conclusions:
Magnetic resonance imaging is the best imaging technique for diagnosis. Total tumor resection improved the surgical results of spinal meningiomas. If total removal of the tumor cannot be achieved, or in the case of early recurrence followed by total resection, radiotherapy should be performed in adjuvant therapy.
Insights
Complete resection of spinal meningiomas significantly improves patient outcomes. Early diagnosis with MRI and surgical intervention are key for successful treatment and minimizing recurrence risks.
Area of Science:
- Neurosurgery
- Oncology
- Radiology
Background:
- Spinal meningiomas are common, typically benign, slow-growing tumors.
- Advancements in imaging and surgical techniques have improved treatment outcomes.
- Complete tumor resection is the primary goal, as incomplete resection can lead to recurrence.
Purpose of the Study:
- To evaluate clinical presentation, diagnostic methods, and therapeutic options for spinal meningiomas.
- To correlate treatment strategies with long-term outcomes in surgically treated patients.
- To present the incidence, localization, and surgical results of spinal meningiomas.
Main Methods:
- Retrospective analysis of 36 patients with histologically confirmed spinal meningiomas (1980-1997).
- Diagnostic imaging included myelography, CT scans, and MRI.
- Surgical treatment involved a posterior approach with microsurgical techniques, CUSA, and CO2 laser when necessary.
Main Results:
- Thoracic region was the most frequent site for spinal meningiomas.
- Complete tumor resection was achieved in 97% of patients.
- 83% of patients showed improvement post-surgery; one operative mortality (3%) due to pulmonary embolism.
Conclusions:
- MRI is the preferred imaging modality for diagnosing spinal meningiomas.
- Total tumor resection is crucial for favorable surgical outcomes.
- Adjuvant radiotherapy may be considered for recurrent tumors or incomplete resections.