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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Intraspinal meningiomas – analysis of management & clinical outcome of 300 surgically treated patients

Intraspinale Meningeome – Analyse des Managements & Outcomes von 300 chirurgisch behandelten Patienten

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  • presenting/speaker Hanah Gull - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Oliver Gembruch - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Marvin Darkwah Oppong - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Alejandro Santos Saint Romain - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Thiemo F. Dinger - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Andreas Kneist - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Yahya Ahmadipour - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Philipp Dammann - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Karsten H. Wrede - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Neriman Oezkan - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP018

doi: 10.3205/22dgnc332, urn:nbn:de:0183-22dgnc3329

Published: May 25, 2022

© 2022 Gull et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Spinal meningiomas are rare diseases of the vertebral column. While cerebral meningiomas have been thoroughly studied, further investigations on spinal meningiomas are urgently needed. This study aimed to evaluate the treatment & outcome of surgically treated patients with spinal meningiomas

Methods: Three hundred patients with histologically confirmed meningiomas were surgically treated from 1990 to 2020. Data collection was based on clinical data, radiological findings, operative reports & postoperative follow-up. McCormick Scale measured pre- & postoperative neurological function. Charlson Comorbidity Index (CCI) was calculated to assess effect of comorbidities on preoperative status & postoperative outcome. Univariate & multivariate analyses were performed to determine significant coherences (p-value ≤ 0.05 was considered statistically significant). Kaplan-Meier & Cox regression analyses were performed to analyze overall survival

Results: Anatomic distribution was 20.3% cervical, 3.3% cervicothoracic, 65.7% thoracic, 0.7% thoracolumbar & 3.7% lumbar, respectively. Furthermore, tumors were classified as ventrally (7.3%), ventrolaterally (29.7%), dorsally (11.1%), dorsolaterally (21.1%) & mediolaterally (2.3%) in relation to the spinal cord. Mean age was 63.1 years, ranging from 20 to 87 (± 14.01 SD). At admission, patients with cervical intraspinal meningiomas presented most frequently paresis of one arm & sensory disorders, whereas cervicothoracic meningioma led to myelopathy symptoms (p<0,05). Thoracic meningiomas mainly caused paraparesis, sensory disturbances & myelopathy symptoms, while thoracolumbar & lumbar meningiomas caused pain/ lumbago as a typical first symptom (p<0.05). 98,7% of all patients showed gross total resection in 6 months FU after surgery. No significant differences in pre- & early postoperative McCormick grades (p=0.111) were detected. However, a trend towards lower McCormick was identified in FU 6 months after surgery of thoracic & lumbar meningiomas (p=0,004). Multivariate analysis confirmed that a high Body Max Index was independently associated with postoperative high McCormick grade (p<0.05). A higher CCI was not related to higher McCormick grades (p=0.367)

Conclusion: Because surgery for intraspinal meningiomas does not result in worsened functional outcome, surgical resection of this tumor entity should be pursued. Further exploration of other BMI-related factors is needed to determine the management & outcome of patients with intraspinal meningiomas