The Clinical and Radiological Outcome of Cervical Spinal Meningioma

Abstract

Objective:We aimed to present the clinical and radiological outcomes of 22 cases of cervical spinal meningiomas. Methods: We retrospectively reviewed 22 patients who were diagnosed with cervical meningioma histologically from May 2003 to May 2017. Their pre-and postoperative clinical features were evaluated by the Japanese Orthopaedic Association (JOA) scale and Neck Disability Index (NDI). Results: There were 6 male and 16 female patients. The mean age was 60 years (20-73 years). The most common preoperative symptom was paresthesia in 15 patients. The craniocaudal tumor extension of less than 3 levels was found in 18 patients. More than 50% of spinal canal compression was observed in 16 patients. Most common location of the dural attachment of the tumor was ventrolateral (54.5%), followed by dorsolateral (18.2%), lateral (13.6%), ventral (9.1%) and dorsal (4.5%) order. Extradural tumor extension was observed in 5 patients. Simpson grade II resection was the most common, with 16 patients. The mean JOA scales were significantly improved from 13.8±2.6 to 15.9±1.0 at postoperative one year (p=0.0004). The mean NDI showed the same results (from 14.6±8.2 to 8.4±6.6; p=0.0005). One patient with Simpson grade IV resection received adjuvant radiotherapy. Two patients had a recurrence of the tumor, one with Simpson grade II resection and the other with Simpson grade III resection. Conclusion: The surgery is the recommended treatment in cases of cervical spinal meningiomas because of its excellent functional improvement and low recurrence rates.

Intradural Extramedullary Concurrent Schwannoma and Meningothelial Hyperplasia at C2-C3 Cervical Vertebrae: A Case Report and Review of Literature

“…Two cases (9.1%) of attempted subtotal resection (Simpson grade IV) had many common features such as the extension of more than two levels in the craniocaudal direction, severe adhesion to the spinal cord, and presence of calcifications. Interestingly, those two patients had no recurrence of their tumor, which is significantly lower than previously reported in the literature; however, limitations of this study by Lee et al include the small case number as well as short follow-up time [ 16 ]. One of these patients underwent adjuvant radiotherapy ten months after surgery.…”

“…Cervical spine meningiomas constitute a very small proportion of spinal schwannomas. The largest case series consists of twenty-two cases of cervical spine meningiomas [ 16 ]. The functional outcome improvement rate after surgery in this study was very good and comparable to the improvement rates generally described for spinal schwannomas [ 16 ].…”

“…The largest case series consists of twenty-two cases of cervical spine meningiomas [ 16 ]. The functional outcome improvement rate after surgery in this study was very good and comparable to the improvement rates generally described for spinal schwannomas [ 16 ]. Two cases (9.1%) of attempted subtotal resection (Simpson grade IV) had many common features such as the extension of more than two levels in the craniocaudal direction, severe adhesion to the spinal cord, and presence of calcifications.…”

“…The overall recurrence rate in this series was 9.1% (2 patients), the patients having received Simpson grade II and Simpson grade III resection, respectively. Despite tumor recurrence, the latter patients did well without additional therapy [ 16 ]. Because of the implications on outcomes and mostly on treatment modalities, the distinction between a schwannoma and meningioma, concurrent schwannoma and meningioma, and concurrent schwannoma and meningothelial hyperplasia becomes important.…”