Spinal Meningiomas: A Longitudinal Surgical Outcome Study

Introduction: Spinal meningiomas, an overall rare tumor with incidence of 0.33/100,000 population, are among the most common intradural spinal tumors, accounting for up to 45%. The aim of this study is to provide longitudinal data on the neurological function and treatment outcome over a decade.

Methods: This single-center retrospective study reviewed consecutive patients with spinal meningiomas who underwent surgery during a 10-year period (2014 and 2024). Demographic characteristics, lesion features, symptomology, surgical treatment, and outcomes were analyzed with uni- and multi-variate analysis.

Results: The study cohort consisted of 47 subjects, 81% women. Predominant races were White and Asian, 34% and 32%, respectively. The mean age at surgery was 65 years (range 25-88). The majority of patients (89%) presented with more than one symptom. These included difficulty ambulating (77%), pain (70%), and numbness or sensory deficit (64%). In 2 patients (4%), the tumor was discovered incidentally, and they were asymptomatic. Most tumors (72%) were located in the in the thoracic segment (72%) ventral to the cord (42%), with maximum longitudinal diameter < 2cm (76%). A gross total resection was achieved in 87% of cases, independent of tumor size and/or location. Histologically, 44/47 (94%) were benign WHO 1 meningiomas, the others were WHO 2. These predominantly occurred in men. Symptoms improved in 79% of patients. The length of stay was 7 +/- 7 days. Recurrence/progression occurred in 10%.

Conclusion : The primary treatment of spinal meningioma remains surgical resection resulting in cure and symptoms amelioration. This study underscores key characteristics of patients with operable spinal meningiomas, equipping care teams with a better understanding of this affected population.