Spinal meningiomas are found in all age groups, predominantly in women aged over 50 years. The clinical symptoms of this condition may range from mild to significant neurological deficit, varying widely depending on the location, position in relation to the spinal cord, size and histological type of the tumor. Magnetic resonance imaging is the diagnostic tool of choice because it shows the location, size, the axial position of the tumor, and the presence of concomitant conditions such as spinal malformations, edema or syringomyelia.  According to the degree of malignancy, the World Health Organization divides meningiomas into three grades: grade I - benign; grade II – atypical, and grade III - malignant. The goal of the surgery is total resection which is achievable in 82%–98% of cases. Advances in radiosurgery have led to its increased use as primary or adjunct therapy. The current paper aims to review the fundamental clinical as-pects of spinal meningiomas such as their epidemiology, clinical presentation, histological characteristics, diagnostics, and management.

Tumours arising from the spinal nerve roots are more common in men between the third and fourth decades of life, located mainly in the intradural space of the lumbar region. The clinical symptoms of spinal schwannomas and neurofibromas are similar and depend on the location of the tumour and its relationship to the spinal cord and nerve roots. The pain (radiculalgia and/or vertebralgia) is the earliest symptom, followed by sensory deficit, while motor deficits and sphincter disorders are late symptoms. Magnetic resonance imaging is the diagnostic tool of choice and should be performed when the disease is suspected, as early and accurate diagnosis is essential for treatment outcome. The treatment of these lesions is surgical aiming at total tumour resection that promotes neurological recovery and prevents from recurrences. Subtotal removal also provides favourable outcome but at higher recurrence rates. The aim of this literature review was to study some important characteristics of sporadic spinal schwannomas (SSS) and neurofibromas (SSN), i.e. those notassociated with neurofibromatosis type I and II.

Background: The purpose of the current study is to identify the correlations between the most important preoperative clinical factors and the outcome of surgery of spinal meningiomas (SM). Methods: We performed a retrospective analysis of the medical history, clinical, paraclinical, neuroimaging, and surgical protocol data in 31 patients with SM who underwent surgical resection at our institution from January 2011 to July 2020. The degree of resection was assessed on the Simpson scale. The modified McCormick scale was used to monitor the effect and outcome of treatment at admission, discharge, and at further follow-up. Results: The average age of the patients was 65 years (37-78). Vertebral pain and motor deficits were the most common initial symptoms that occurred in 26 (89.6%) and 29 (93.5%) patients, respectively. Sphincter disorders were found in 9 (29%) patients. Total resection (Simpson Grade I – II) was achieved in 29 patients (93.5%). We achieved a favorable outcome (McCormick Gr. I to III) in 93.3% of patients. The degree of the neurological deficit (P = 0.026) and the presence of sphincter disorders (P = 0.009) were the preoperative clinical factors that most significantly correlated with the outcome of treatment. Conclusion: The outcome from the surgical treatment of SM correlated significantly with the degree of the preoperative neurological deficit. Therefore, patients presenting with more severe symptoms are expected to have worse outcomes.

Background Intradural lipomas (IL) not associated with spina bifida in the lumbar region are rare and isolated cases have been reported in the literature. The current paper presents a case of a patient who suffers from intradural lipoma without spinal dysraphism in the lumbar region. We also made a brief literature review. Case presentation: A 31-year-old patient suffered from back pain resistant to medication for more than a year. Few weeks prior to hospitalization, the pain irradiated to the feet associated with numbness, weakness and urinary dysfunction. Upon hospitalization, partial cauda equina syndrome was diagnosed that included radiculopathy along L4-S1 nerve roots, predominantly on the left side, decreased tendon reflexes, left-sided fibular and tibial paresis. Partial urinary retention was also present. Magnetic resonance tomography demonstrated a lesion located in the dorsal intradural space at the level of L3–L4 vertebra that had fat-equivalent ovoid form compressing and dislocating the components of the dural sac ventrally. Laminectomy of L3 and L4 vertebrae was performed. We encountered an intradural tumor formation with a yellowish colour and that was adherent to the nerve roots of cauda equina. After microsurgical dissection of the nerve roots, the tumor was partially resected. The histological examination confirmed the diagnosis of lipoma. Postoperatively, the neurological status improved significantly. The pain syndrome, motor symptoms and pelvic reservoir dysfunction were reduced. Conclusions In cases with intradural lipomas, the earliest possible surgical decompression with maximal safe resection of the lesion is a therapeutic method of choice that results in significant improvement or complete recovery of the neurological deficit.