Artikel
Spinal meningiomas: Critical analysis of 131 surgically treated cases
Spinale Meningeome: Kritische Analyse von 131 chirurgisch behandelten Fällen
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Veröffentlicht: | 11. April 2007 |
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Objective: This study was undertaken to analyze the functional outcome of surgically treated spinal meningiomas and to determine sources of operative morbidity.
Methods: Between January 1990 and December 2005 a total of 131 patients underwent surgical resection of a spinal menigioma. There were 114 female (87%) and 17 male (13%) patients. Age ranged from 17 to 88 years (mean 69 years). The mean follow-up period was 4 months (range 1 to 108 months) including a complete neurological examination and postoperative MRI studies. The pre and postoperative neurological state was graded according to the Frankel Scale. Surgery was performed under standard microsurgical conditions with neurophysiological monitoring.
Results: In 95 patients (72,5%), the lesion was located in the thoracic region, in 21 patients (16.0%) in the cervical region, in 7 patients at the cervico-thoracic junction, in 6 patients at the thoraco-lumbar junction and in 2 patients in the lumbar region. Surgical resection was complete in 127 patients and subtotal in 4 patients. Transient neurological deterioration was observed in 16 cases. At the last follow-up, the neurological state was improved or unchanged in 121 patients (92%) and worse in 10 patients (8%) compared to the preoperative condition. Two patients died due to non surgically related complications and 1 patient due to a tumor progression.
Conclusions: Radical resection of spinal meningiomas can be performed with good functional results. Extensive tumor calcification and arachnoid adhesions to the surrounding neural tissue proved to harbor an increased risk for surgical morbidity.