Delayed recovery from paraplegia following resections of thoracic meningiomas

Abstract

Background: In this retrospective study, we evaluated the patterns of postoperative recovery for patients who were initially paraplegic before the excision of thoracic spine meningiomas. We also determined how the various prognostic factors impacted outcomes. Methods: Twenty patients with paraplegia underwent surgical excision of thoracic spine meningiomas at 2016– 2019. Patients’ demographics, clinical, radiological data, operative details, histopathology, and postoperative complications were recorded; patients were reassessed at 6 months and 1 year postoperatively. Results: Fourteen patients improved postoperatively, becoming, ambulatory with/without assistance; only six remained paraplegic. Poor prognostic factors for postoperative motor recovery included larger tumor size, longer duration of preoperative symptoms/paraplegia, and greater severity of sensory loss. Conclusion: For 6/20 patients with thoracic meningiomas, poor postoperative recovery of motor function correlated with larger tumor size, longer duration of preoperative symptoms/paraplegia, and more severe sensory loss.

Recovery Potential of Spinal Meningioma Patients With Preoperative Loss of Walking Ability Following Surgery – A Retrospective Single-Center Study

“…Unlike the findings of the present study, the delay from symptom onset (also including other symptoms than loss of walking ability) to surgery was not associated with the functional outcome. Ashry et al [ 12 ] retrospectively studied the results of surgery on thoracic meningiomas in a sample of 20 paraplegic patients (75% women; median age, 49 years). Opposing the findings of this study, during the postoperative follow-up, 70% of the paraplegic patients recovered to at least assisted walking of whom all had their surgery within 2 weeks after the onset of paraplegia.…”

Two out of three of octogenarians benefitted from delayed resection of spinal meningiomas

“…also reported the surgical outcomes of 20 patients who were paraplegic due to thoracic meningiomas of whom 14 patients recovered, and all of them had surgery within 14 days from the onset of paralysis. [ 1 ] When Schwake et al . studied 88 patients with spinal meningiomas, 73% of which were thoracic, motor deficits improved with surgery in 37 of 84 patients, while two deteriorated in the postoperative period.…”

“…Ashry et al also reported the surgical outcomes of 20 patients who were paraplegic due to thoracic meningiomas of whom 14 patients recovered, and all of them had surgery within 14 days from the onset of paralysis. [1] When Schwake et al studied 88 patients with spinal meningiomas, 73% of which were thoracic, motor deficits improved with surgery in 37 of 84 patients, while two deteriorated in the postoperative period. [5] CONCLUSION Two out of three octogenarians with long-standing, severe preoperative paraparesis/paraplegia due to thoracic meningioma significantly benefitted from 60-289 day delayed surgery.…”