Correlations between preoperative clinical factors and treatment outcome of spinal meningiomas – A retrospective study of a series of 31 cases

Abstract

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.

Current Knowledge on Spinal Meningiomas Epidemiology, Tumor Characteristics and Non-Surgical Treatment Options: A Systematic Review and Pooled Analysis (Part 1)

“…The terms calcified and ossified are often used interchangeably. Interestingly, two studies [ 70 , 75 ] noticed that intratumoral calcification patterns matched the hypointense areas in tumors that were heterogeneously enhancing on contrast MRI, possibly due to a reduced uptake of contrast in calcified regions. One study [ 70 ] mentioned that calcified tumors that were homogenously contrast enhancing tended to exhibit a more homogenous, diffuse, and low-grade calcification pattern.…”

Unsuccessful external validation of the MAC-score for predicting increased MIB-1 index in patients with spinal meningiomas

“…In our experience, length of hospital stay reflects local referral structures between surgical clinics and rehab centers as much as actual clinical aspects. Regarding the latter, more complex surgeries, complications, ( 16 , 39 ) and the management of patients with comorbidities are likely to result in prolonged hospital stay. Conversely, as argued above, the evidence suggests that calcified tumors with a low MIB-1 index, rather than tumors with a high MIB-1 index, are associated with more surgical complications and longer hospital stays ( 22 , 26 , 27 ).…”

“…( 9 , 15 ) A tumor was deemed calcified when it was hyperintense on CT, reflecting a density close to that of adjacent bony structures, or when the tumor had decreased signal intensity on T1 and T2. ( 9 , 16 ) Tumor growth was defined as the radiological growth of a tumor remnant following subtotal resection, while tumor recurrence was defined as the appearance of a new spinal meningioma following total resection. All histopathological analyses were performed at the Department of Pathology, Karolinska University Hospital, Stockholm, Sweden.…”