Spinal Meningiomas
Spinal Meningiomas
Advances in imaging and surgical technique have improved the treatment of spinal meningiomas; these include magnetic resonance imaging, intraoperative ultrasonography, neuromonitoring, the operative microscope, and ultrasonic cavitation aspirators. This study is a retrospective review of all patients treated at a single institution and with a pathologically confirmed diagnosis of spinal meningioma. Additionally the authors analyze data obtained in 556 patients reported in six large series in the literature, evaluating surgical techniques, results, and functional outcomes. Overall, surgical treatment of spinal meningiomas is associated with favorable outcomes. Spinal meningiomas can be completely resected, are associated with postoperative functional improvement, and the rate of recurrence is low.
Spinal meningiomas represent 25 to 46% of tumors of the spine. Typically, they are located in the intradural extramedullary space, grow slowly, and spread laterally in the subarachnoid space until they induce symptoms. They most frequently occur in the thoracic region in middle-aged women. Patients typically present with pain, sensory loss, weakness, and sphincter disturbances. Advances in radiological and surgical assistive devices (MR imaging, neuromonitoring, intraoperative ultrasonography, operative microscope, and ultrasonic surgical aspirator) have resulted in earlier diagnosis and aided in obtaining a total resection. Prognosis in patients with spinal meningiomas is excellent, and even patients with a poor preoperative neurological status can respond favorably to surgery.
The purpose of this study is threefold. First, we describe a case of spinal meningioma and provide radiological and intraoperative findings, as well as a video, demonstrating the typical presentation and surgical treatment of spinal meningiomas. Second, we review a recent series of 25 patients in whom spinal meningiomas were resected. Finally, we review the literature to determine the various surgical management strategies for spinal meningiomas.
Advances in imaging and surgical technique have improved the treatment of spinal meningiomas; these include magnetic resonance imaging, intraoperative ultrasonography, neuromonitoring, the operative microscope, and ultrasonic cavitation aspirators. This study is a retrospective review of all patients treated at a single institution and with a pathologically confirmed diagnosis of spinal meningioma. Additionally the authors analyze data obtained in 556 patients reported in six large series in the literature, evaluating surgical techniques, results, and functional outcomes. Overall, surgical treatment of spinal meningiomas is associated with favorable outcomes. Spinal meningiomas can be completely resected, are associated with postoperative functional improvement, and the rate of recurrence is low.
Spinal meningiomas represent 25 to 46% of tumors of the spine. Typically, they are located in the intradural extramedullary space, grow slowly, and spread laterally in the subarachnoid space until they induce symptoms. They most frequently occur in the thoracic region in middle-aged women. Patients typically present with pain, sensory loss, weakness, and sphincter disturbances. Advances in radiological and surgical assistive devices (MR imaging, neuromonitoring, intraoperative ultrasonography, operative microscope, and ultrasonic surgical aspirator) have resulted in earlier diagnosis and aided in obtaining a total resection. Prognosis in patients with spinal meningiomas is excellent, and even patients with a poor preoperative neurological status can respond favorably to surgery.
The purpose of this study is threefold. First, we describe a case of spinal meningioma and provide radiological and intraoperative findings, as well as a video, demonstrating the typical presentation and surgical treatment of spinal meningiomas. Second, we review a recent series of 25 patients in whom spinal meningiomas were resected. Finally, we review the literature to determine the various surgical management strategies for spinal meningiomas.
