Spinal Meningiomas

Tsai, Eve C.; Butler, J. M.; Benzel, Edward C.

doi:10.1007/978-1-84628-784-8_57

Cited by 4 publications

(8 citation statements)

References 54 publications

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“…They have a predilection for thoracic spine (67–84% thoracic meningiomas; Gottfried et al .). [ 3 , 6 ] Although 90% are benign, 10% may undergo malignant degeneration (WHO Grade III are the malignant ones). [ 4 ]…”

Section: Discussionmentioning

confidence: 99%

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Circumferential intradural meningioma of the thoracic spine: Case report and literature review

Bisht

Laurente

Joshi

2021

Surgical Neurology International

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Background: Meningiomas are common intradural extramedullary spinal tumors with a predilection for the thoracic spine. They are mostly benign (90%), with only a few showing malignant potential. However, circumferential intradural meningiomas surrounding the spinal cord are exceptionally rare. Here, we present a 40-year-old patient with a T6-T7 circumferential lesion who underwent surgery. In addition, we reviewed three similar cases previously reported in the literature. Case Description: A 40-year-old female presented with paraparesis. Imaging demonstrated a T6-T7 thoracic circumferential intradural lesion, considered to most likely be a meningioma. At surgery, the posterolateral portion of the tumor was removed, but there was residual ventral disease. The tumor recurred several years later, and was again partially removed, now leaving her with a residual neurological deficit. Three similar cases of circumferential meningiomas, one cervical and two thoracic, were reported from the literature. Conclusion: Circumferential meningiomas pose unique and significant surgical challenges, particularly since resection of the posterolateral components is feasible, but some tumor may have to be left ventrally to avoid injury to the anterior spinal artery, that may recur.

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Section: Discussionmentioning

confidence: 99%

“…Most tumors are located posterior/lateral to the spinal cord, with fewer found anteriorly. [ 3 , 6 ]…”

Section: Discussionmentioning

confidence: 99%

Circumferential intradural meningioma of the thoracic spine: Case report and literature review

Bisht

Laurente

Joshi

2021

Surgical Neurology International

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“…9 Furthermore, stretching of the nervous structures due to anomalous movement of the spine is a well-recognised mechanism of sudden clinical presentation, albeit exceptional in patients with spinal meningiomas. 4,5 The mechanism underlying clinical symptomatology due to cord and root stretching changes according to the anatomical position of the conus and the absence or presence of tethered cord. In patients with tethered cord and the conus in the lower position, the symptoms may be caused even by minor trauma, sudden efforts, exaggerated bending of the back or pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…This may be due to tumour haemorrhage, 6 cord compression by a concomitant spine trauma 7 or tethering of the nerve roots and/or cord. 4 We report a case of spinal meningioma of the low thoracic region, presenting as sudden post-traumatic right sciatica and right leg weakness, due to cord and root stretching.…”

Section: Introductionmentioning

confidence: 99%

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Sudden post-traumatic sciatica caused by a thoracic spinal meningioma

et al. 2016

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Spinal meningiomas usually present with slowly progressive symptoms of cord and root compression, while a sudden clinical onset is very rare. A 35-year-old previously symptom-free woman presented sudden right sciatica and weakness of her right leg following a fall with impact to her left foot. A neurological examination showed paresis of the right quadriceps, tibial and sural muscles, increased bilateral knee and ankle reflexes and positive Babinski sign. Magnetic resonance imaging (MRI) revealed the presence of a spinal T11 meningioma in the left postero-lateral compartment of the spinal canal; at this level, the spinal cord was displaced to the contralateral side with the conus in the normal position. At surgery, a meningioma with dural attachment of the left postero-lateral dural surface was removed. The intervention resulted in rapid remission of both pain and neurological deficits. Spinal meningiomas may exceptionally present with sudden pain and neurological deficits as result of tumour bleeding or post-traumatic injury of the already compressed nervous structures, both in normal patients and in those with conus displacement or tethered cord. In this case, the traumatic impact of the left foot was transmitted to the spine, resulting in stretching of the already compressed cord and of the contralateral lombosacral roots. This case suggests that low thoracic cord compression should be suspected in patients with post-traumatic radicular leg pain with normal lumbar spine MRI.

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

Davarski

Kitov

Apostolov

et al. 2021

Surgical Neurology International

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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.

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Spinal Meningiomas

Cited by 4 publications

References 54 publications

Circumferential intradural meningioma of the thoracic spine: Case report and literature review

Circumferential intradural meningioma of the thoracic spine: Case report and literature review

Sudden post-traumatic sciatica caused by a thoracic spinal meningioma

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

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