Data on intraoperative neurophysiological monitoring (IOM) during spinal meningioma (SM) surgery are scarce. The aim of this study was to assess the role of IOM and its impact on post-operative functional outcome. Eighty-six consecutive surgically treated SM patients were included. We assessed pre and post-operative Modified McCormick Scale (mMCS), radiological and histopathological data and IOM findings. Degree of cord compression was associated with preoperative mMCS and existence of motor or sensory deficits (p < 0.001). IOM was used in 51 (59.3%) patients (IOM-group). Median pre and post-operative mMCS was II and I, respectively (p < 0.001). Fifty-seven (66.3%) patients showed an improvement of at least one grade in the mMCS one year after surgery. In the IOM group, only one patient had worsened neurological status, and this was correctly predicted by alterations in evoked potentials. Analysis of both groups found no significantly better neurological outcome in the IOM group, but IOM led to changes in surgical strategy in complex cases. Resection of SM is safe and leads to improved neurological outcome in most cases. Both complication and tumor recurrence rates were low. We recommend the use of IOM in surgically challenging cases, such as completely ossified or large ventrolateral SM.

We show that the moduli space of positive Ricci curvature metrics on all the total spaces of $$S^7$$ S 7 -bundles over $$S^8$$ S 8 which are rational homology spheres has infinitely many path components. Furthermore, we carry out the diffeomorphism classification of quotients of Milnor spheres by a certain involution and show that the moduli space of metrics of non-negative sectional curvature on them has infinitely many path components. Finally, a diffeomorphism finiteness result is obtained on quotients of Shimada spheres by the same type of involution and we show that for the types that can be expressed by an infinite family of manifolds, the moduli space of positive Ricci curvature metrics has infinitely many path components.

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