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Neuro-oncological features of spinal meningiomas: Systematic review
B Jamilson Araújo Pereira1, A Nogueira de Almeida2, W Silva Paiva1
1Departamento de Neurologia da Faculdade de Medicina da Universidade de São Paulo, Rua Martiniano de Carvalho, 669, Edifício Paulista Paradise Life, Apto 1105, Brasil.
Purpose:
Review the published data on spinal meningioma (SM) to create a more comprehensive picture of its natural history.
Methods:
A review of the published SM literature was carried out through a Medline search up to December 2018. The search using the keyword "spinal meningiomas" returned 248 papers and the parameters analyzed in our present study were examined in those publications. Papers without a detailed description of clinical findings, neuroimaging confirmation of the spinal tumor, minimum follow-up of 5 years, or a clear description of the clinical findings were excluded.
Results:
In the 24 manuscripts reviewed, 1811 (1450 females/361 males) patients with SM were analyzed. The thoracic spine (1181-64.6%) and cervical spine (394-22.7%) were the more prevalent levels. The psammomatous (27.8%) and meningothelial variants (25.2%) were the most prevalent histopathological subtypes. Gross total resection (Simpson I and II) was achieved in 94.5% of cases and subtotal resection (Simpson III or more) in 5.5%. The tumor recurrence rate was 4.4%, and the mortality rate related to surgery or disease progression was 3%.
Conclusion:
WHO grade I predominance was observed among spinal meningiomas, analogous to intracranial meningiomas. SMs predominated in the thoracic spine. Surgery with gross total resection was achieved in the vast majority of cases, resulting in low recurrence and mortality rates.
