Spinal meningiomas: is Simpson grade II resection radical enough?

Area of Science:

• Neurosurgery
• Oncology
• Spinal Surgery

Background:

• Complete resection is the optimal treatment for spinal meningioma.
• Resection radicality is the primary predictor of tumor recurrence.
• Limited data exists on optimal follow-up duration and recurrence rates for Simpson grade I vs. II resections.

Purpose of the Study:

• To re-evaluate surgical treatment strategies and long-term follow-up protocols for spinal meningiomas.
• To analyze tumor recurrence rates based on Simpson grade II resection in a retrospective cohort.
• To determine the impact of follow-up duration on observed recurrence rates.

Main Methods:

• Retrospective analysis of 84 patients who underwent Simpson grade II resection for spinal meningioma between 1998 and 2018.
• Data collected included clinical presentation, demographics, tumor location, resection extent, recurrence, and complications.
• Patient follow-up duration ranged from 1 to 204 months.

Main Results:

• Spinal meningiomas were more common in women (81%) with a mean age of 65 years.
• Most tumors were thoracic (82%), with motor deficits (80%) and sensory changes (70%) as primary symptoms.
• Overall recurrence rate was 5%, but in patients followed >6 years, recurrence was 44% (all women, mean age 51).

Conclusions:

• Tumor recurrence after Simpson grade II resection may be underestimated with shorter follow-up periods.
• Long-term monitoring is crucial, particularly for younger patients and women.
• Consideration should be given to increasing the use of Simpson grade I resection for spinal meningiomas.