Review of 36 cases of spinal cord meningioma

Study Design. Thirty-six consecutive patients with histologically confirmed spinal cord meningioma were presented to evaluate clinical, diagnostic, therapeutic options and to correlate treatment methods and outcome. Objective. To present the incidence, clinical presentation, localization, techniques, and long term results of surgically treated spinal meningiomas. Summary of Background Data. Meningiomas are common tumors of spinal neoplasm. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. However, spinal meningiomas may recur, especially as a result of incomplete resection. Methods. Thirty-six consecutive patients with histologically confirmed spinal meningiomas were treated from 1980 to 1997. Neuroradiological diagnosis was made through myelogram in 20 patients, CT scan in 15 patients, and MRI in 16 patients. All patients were operated on via the posterior approach and using microsurgical technique and when necessary Cooper-Ultrasonic surgical aspirator (CUSA) and CO2 laser were also applied. The patients were followed for 2 to 15 years (mean 9 years). Radiotherapy was not undertaken except in recurrent tumors. Results. The most frequent site of spinal meningiomas was in the thoracic region. In 30 (83%) patients tumors were found to be completely intradural extramedullary during surgery. Total tumor resection was achieved in 35 (97%) of patients. In the follow-up period, 30 cases (83%) improved when compared to their preoperative conditions. There was one operative mortality (3%). A 66-year-old women died of pulmonary emboli. Conclusions. Magnetic resonance imaging is the best imaging technique for diagnosis. Total tumor resection improved the surgical results of spinal meningiomas. If total removal of the tumor cannot be achieved, or in the case of early recurrence followed by total resection, radiotherapy should be performed in adjuvant therapy.