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Journal of Neuro-Oncology

, Volume 140, Issue 1, pp 49–54 | Cite as

Spinal meningioma and factors predictive of post-operative deterioration

  • Vianney Gilard
  • Alice Goia
  • François-Xavier Ferracci
  • Florent Marguet
  • Nicolas Magne
  • Olivier Langlois
  • Alexis Perez
  • Stéphane Derrey
Clinical Study

Abstract

Purpose

Spinal meningiomas are slow-growing intradural-extramedullary tumors. They are usually associated with good outcomes. However, there are few descriptions of factors predictive of impaired evolution. Our objective was to identify predictive factors of post-operative deterioration as well as outcomes at follow-up.

Methods

Between 2009 and 2016, 87 patients had surgery for spinal meningioma in our referral center. Clinical presentation, management and outcomes were reported during the post-operative period and at 3-month follow-up. Evaluation was based on post-operative neurological deterioration defined as an increase of at least one point in the McCormick score compared to the status at admission.

Results

During the study period, post-operative deterioration occurred in 17 patients (19.5%). Risk factors associated with this deterioration were the absence of pre-operative neurological signs (Relative Risk; RR = 2.38, p = 0.04), an anterior location of the meningioma and a grade 2 meningioma on WHO classification score (RR = 6, p ≤ 0.01). At 3-month follow-up, in patients who initially presented with a motor deficit, partial recovery was found in 75%, stability in 20% and a deterioration of their clinical status in 5%. After a mean follow-up of 92.4 ± 51.9 months, the recurrence rate was 8%.

Conclusions

Spinal meningiomas are usually benign tumors whose treatment is based on complete surgical resection. Progress in surgical techniques has resulted in lower morbidity rates and improvement in post-operative recovery. In this study, we observed several factors associated with clinical deterioration. Before surgery, patients should be fully informed of these predictive factors of post-operative deterioration and their association with surgical morbidity.

Keywords

Spinal meningioma Surgical outcome Prognostic factors Spinal tumor Intradural Extramedullary 

Notes

Acknowledgements

The authors are grateful to Nikki Sabourin-Gibbs, Rouen University Hospital, for her help in editing the manuscript.

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryRouen University HospitalRouenFrance
  2. 2.Normandie Univ, UNIROUEN, INSERM U1245, Laboratory of Microvascular Endothelium and Neonate Brain LesionsRouenFrance
  3. 3.Department of NeuropathologyRouen University HospitalRouenFrance
  4. 4.Department of RadiologyRouen University HospitalRouenFrance
  5. 5.Normandie Univ, UNIROUEN, INSERM UMR 1073, Laboratory Nutrition, Gut and BrainRouenFrance

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