Spinal meningiomas – experience from two centres
Authors:
Koleják R. 1; Koleják K. 2; Šedivý O. 2; ; Šimeg V. 2; Přibáň V. 1
Authors‘ workplace:
Neurochirurgická klinika, LF UK a FN Plzeň, ČR
1; Neurochirurgická klinika, FNsP Nitra, Slovensko
2
Published in:
Cesk Slov Neurol N 2025; 88(1): 53-57
Category:
Original Paper
doi:
https://doi.org/10.48095/cccsnn202553
Overview
Introduction: Spinal meningiomas are the most common intradural tumors of the spine, typically benign and usually with a good overall prognosis. These tumors are usually localized in the thoracic region and occur pedominantly in female population. Authors present a group of patients operated between 2000–2021 in Pilsen (Czech Republic) and between 2010–2023 in Nitra (Slovak republic). Patients and methods: The following parameters were evaluated: sex, age, localization of the tumor, clinical presentation, type of surgical approach, and use of neurophysiological monitoring. Preoperative and postoperative clinical condition was assessed using the Nurick scale. Statistical analysis was performed. Results: The group consisted of 139 patients (87 Pilsen, 52 Nitra) of which 109 were females (78%), with an average age of 63.4 years. The most common localization of the tumor was the thoracic region (71%). The dominant symptom was paraparesis of lower limbs (60%), followed by Brown-Séquard syndrome (17%) and radiculopathy (16%). 4% of patients were asymptomatic. The preferred surgical approach was laminectomy (91%), in 45% the resection was performed under neurophysiological monitoring. Average Nurick grade preoperatively was 2.72, and postoperatively it was 1.62. Several statistically significant factors leading to a bad outcome (defined as Nurick grade 3 or more postoperatively) were identified. Males have 3.9× increased risk of a bad outcome (P = 0.048). Higher Nurick grade preoperatively is associated with higher risk of a bad outcome – 26.6× higher with Nurick 3–5 (P < 0.0001), and 48.9× higher with Nurick 4–5 (P < 0.0001). Patients over 70 years of age have a 3.8× higher risk of a bad outcome (P = 0.0006) and patients aged 80 years and over have a 26.6× higher risk of a bad outcome (P < 0.0001). Conclusion: Surgical treatment of spinal meningiomas belongs to the brighter side of neurosurgery. The goal should be a timely diagnosis followed by radical surgical resection accompanied by neurophysiological monitoring in patients aged less than 80 years with the preserved ability to walk.
Keywords:
Meningioma – spinal meningioma – outcome – neurophysiological monitoring
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Paediatric neurology Neurosurgery NeurologyArticle was published in
Czech and Slovak Neurology and Neurosurgery
2025 Issue 1
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