Spinal meningioma and factors predictive of post-operative deterioration
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.
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.
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%.
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.
KeywordsSpinal meningioma Surgical outcome Prognostic factors Spinal tumor Intradural Extramedullary
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.
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 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.
- 4.Banan R, Hartmann C (2017) The new WHO 2016 classification of brain tumors—what neurosurgeons need to know. Acta Neurochir (Wien)Google Scholar
- 11.Gottfried ON, Gluf W, Quinones-Hinojosa A et al (2003) Spinal meningiomas: surgical management and outcome. Neurosurg Focus 14:1–7Google Scholar
- 18.Reszec J, Hermanowicz A, Rutkowski R et al (2015) Expression of MMP-9 and VEGF in meningiomas and their correlation with peritumoral brain edema. BioMed Res Int 2015:1–8Google Scholar
- 25.Kim CH, Chung CK, Lee S-H et al (2015) Long-term recurrence rates after the removal of spinal meningiomas in relation to Simpson grades. Eur Spine JGoogle Scholar
- 34.McGirt MJ, Chaichana KL, Atiba A et al (2008) Incidence of spinal deformity after resection of intramedullary spinal cord tumors in children who underwent laminectomy compared with laminoplastyGoogle Scholar