Predisposing Factors for Spinal Meningiomas: Cohort Study and Literature Review

Introduction: Spinal meningiomas (SM) account for a significant proportion of primary spinal tumors. Whereas predisposing factors for cranial meningiomas are well defined, those for SM are not. The aim of this study is to analyze SM predisposing factors in our institutional cohort and other cohorts published in recent literature.

Methods: We conducted a retrospective chart review of patients who underwent SM surgery for the period 2014-2024 at a large urban institution. Demographic and clinical characteristics were analyzed through descriptive statistics to identify common predisposing factors. Additionally, we conducted a literature review of published studies on spinal meningioma patients (2000-2024).

Results: In our cohort, 81% of patients were women. Predisposing factors identified for the patients with cranial meningioma included multiple meningiomas 4.3%, neurofibromatosis (NF, (4.3%), other malignancies (19.1%), a history of breast cancer (6.4%) and history of hormonal birth control (6.4%). We analyzed 116 papers from the literature, which included data from 47,899 patients, across which 76.2% were women. Of papers reporting predisposing factors, NF was the most commonly reported factor (n=18, average incidence 6.49%). 13 studies reported patients with multiple meningiomas, 2 papers reported other malignancies and 1 paper reported on breast cancer and 1 paper reported on previous exposure to radiation, a well-known predisposing factor in the cranial meningioma population.

Conclusion : The results from our institutional cohort analysis and literature review highlight that female gender and NF may be predisposing factors. However, gaps in the literature indicate further studies should be conducted to broadly explore other predisposing factors. Such studies could help inform research on the pathogenesis of spinal meningiomas and influence treatment paradigms and clinical reasoning.