Spinal Meningiomas

Abstract

Objectives and Introduction: This study aims to present the cases and surgical outcomes of 14 cases of spinal meningiomas, along with an updated review of the medical literature of the disease. Spinal meningiomas are benign neoplasms that account for 25% to 50% of all intradural extramedullary tumors, and with a prevalence of up to 2:100,000/year, primarily affecting female adults. Treatment is primarily surgical. Patients and methods: We selected patients with diagnosis of spinal meningiomas, admitted in three different Brazilian hospital facilities from January 1995 to January 2014. Later, the cases were analyzed for age, clinical and neurological examination, neuroimaging studies, treatment, histopathological examination and prognosis. Results and Conclusion: Ten patients were female and four male with average age of 53 years. Pain was present in all patients; twelve patients (85%) had abnormal motor function in the lower limbs; paresthesia in eight (57%) and hypoesthesia in four (28%); sphincter changes in four (28%) and Brown-Sequard syndrome in one case (7%). Thirteen patients (92%) underwent laminectomy, and one patient (7%) was submitted to laminoplasty. During the follow-up sensory changes were present in six (42%), abnormal motor function in four (28%), urinary incontinence in two (14%) and neuropathic pain in one patient (7%). The extent of resection is considered the most important factor in determining the rate of recurrence. In this work, “en bloc” resection was possible in most of the cases. Recurrence risk in five years after total resection of the tumor was null, and in ten years was 13%. Spinal arachnoiditis is the most frequent complication in postoperative period, which has a poor prognosis.