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, th erapeutic options and to correlate treatment methods and outcome. Objective. To present the incidence, clinical presentation, localization, t echniques, and long term results of surgically treated spinal meningiomas. Summary of Background Data. Meningiomas are common tumors of spinal neoplas m. They are generally benign and slow-growing. Advanced in radiologic and s urgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. However, spinal men ingiomas may recur, especially as a result of incomplete resection. Methods. Thirty-six consecutive patients with histologically confirmed spin al 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 an d using microsurgical technique and when necessary Cooper-Ultrasonic surgic al aspirator (CUSA) and CO2 laser were also applied. The patients were foll owed for 2 to 15 years (mean 9 years). Radiotherapy was not undertaken exce pt in recurrent tumors. Results. The most frequent site of spinal meningiomas was in the thoracic r egion. In 30 (83%) patients tumors were found to be completely intradural e xtramedullary during surgery. Total tumor resection was achieved in 35 (97% ) of patients. In the follow-up period, 30 cases (83%) improved when compar ed 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 d iagnosis. Total tumor resection improved the surgical results of spinal men ingiomas. If total removal of the tumor cannot be achieved, or in the case of early recurrence followed by total resection, radiotherapy should be per formed in adjuvant therapy.