Spinal meningiomas: prognosis and recovery factors in 22 cases with severe motor deficits

The 22 cases of spinal meningioma with severe motor deficit operated on during a 34-year span are reviewed. The motor deficit is graded according to a modified version of the scale proposed by Levy et al. in 1982, their grade IV being split into grade IV (toe movements and muscular concentrations) and grade V (paraplegia). All 10 grade IV patients were able to walk normally within a year of surgical treatment while only 50% of the grade V patients (12 cases) recovered, and then not completely. The preoperative duration of the motor deficit and age under 60 influenced the speed of recovery in the grade IV patients and the possibility of recovery in the grade V cases. We consider that the dual mechanism of mechanical and ischemic trauma played an important part in the speed and possibility of recovery in the patients reviewed.