199. Functional outcome and long-term follow up results after surgery for spinal meningiomas: a population-based cohort study

Abstract

BACKGROUND CONTEXT Spinal meningiomas are rare entities where the first line of treatment is surgical resection. However, data on functional outcome after long-term follow-up is scarce. PURPOSE The aim of this study was to describe the demographics, histopathological distribution, symptomatology, surgical treatment strategies, functional outcome and long-term follow-up results, for patients surgically treated for spinal meningiomas. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE Patients undergoing surgery for spinal meningiomas. OUTCOME MEASURES Postoperative functional outcome according to modified McCormick scale. Reoperation due to tumor progression or recurrence. METHODS A population-based cohort-study was conducted of all adult patients who underwent surgery for spinal meningiomas between 2005 and 2017, where 131 patients were included in the study. RESULTS The mean age was 63 years and 82% were female. Tumor localization was 31% cervical and 69% thoracic and 98% were WHO grade I. The mean preoperative modified McCormick scale was 2.2 ± 0.9.The mean time from diagnosis to surgery was 3.8 months, and the mean treatment range was 2.6 spinal levels. Gross total resection was achieved in 111 cases (85 %), and mean Simpson grade was 2.4 ± 0.7 as there were no Simpson grade 1 cases. During a mean follow-up time of 4.3 ± 2.9 years, local tumor progression was observed in three (2.3 %) and local tumor recurrence in another three patients. Only two patients underwent renewed tumor resection. The mean postoperative modified McCormick scale was 1.7 ± 0.9. Compared to the preoperative status, surgery was associated with a significant decrease in modified McCormick scale (p CONCLUSIONS Surgery for spinal meningiomas was associated with significant clinical improvement and long-term tumor control could be achieved even without reaching Simpson grade 1 resection. Time from diagnosis to surgery was identified as the single most important independent predictor for favorable functional outcome. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.