Vianney Gilard1,2, Alice Goia3, François-Xavier Ferracci3, Florent Marguet4,5, Nicolas Magne6, Olivier Langlois3, Alexis Perez3, Stéphane Derrey3,7. 1. Department of Neurosurgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France. vianney.gilard@chu-rouen.fr. 2. Normandie Univ, UNIROUEN, INSERM U1245, Laboratory of Microvascular Endothelium and Neonate Brain Lesions, 76000, Rouen, France. vianney.gilard@chu-rouen.fr. 3. Department of Neurosurgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France. 4. Normandie Univ, UNIROUEN, INSERM U1245, Laboratory of Microvascular Endothelium and Neonate Brain Lesions, 76000, Rouen, France. 5. Department of Neuropathology, Rouen University Hospital, 76000, Rouen, France. 6. Department of Radiology, Rouen University Hospital, 76000, Rouen, France. 7. Normandie Univ, UNIROUEN, INSERM UMR 1073, Laboratory Nutrition, Gut and Brain, 76000, Rouen, France.
Abstract
PURPOSE: Spinal meningiomas are slow-growing intradural-extramedullary tumors. They are usually associated with good outcomes. However, there are few descriptions of factors predictive of impaired evolution. Our objective was to identify predictive factors of post-operative deterioration as well as outcomes at follow-up. METHODS: Between 2009 and 2016, 87 patients had surgery for spinal meningioma in our referral center. Clinical presentation, management and outcomes were reported during the post-operative period and at 3-month follow-up. Evaluation was based on post-operative neurological deterioration defined as an increase of at least one point in the McCormick score compared to the status at admission. RESULTS: During the study period, post-operative deterioration occurred in 17 patients (19.5%). Risk factors associated with this deterioration were the absence of pre-operative neurological signs (Relative Risk; RR = 2.38, p = 0.04), an anterior location of the meningioma and a grade 2 meningioma on WHO classification score (RR = 6, p ≤ 0.01). At 3-month follow-up, in patients who initially presented with a motor deficit, partial recovery was found in 75%, stability in 20% and a deterioration of their clinical status in 5%. After a mean follow-up of 92.4 ± 51.9 months, the recurrence rate was 8%. CONCLUSIONS: Spinal meningiomas are usually benign tumors whose treatment is based on complete surgical resection. Progress in surgical techniques has resulted in lower morbidity rates and improvement in post-operative recovery. In this study, we observed several factors associated with clinical deterioration. Before surgery, patients should be fully informed of these predictive factors of post-operative deterioration and their association with surgical morbidity.
PURPOSE:Spinal meningiomas are slow-growing intradural-extramedullary tumors. They are usually associated with good outcomes. However, there are few descriptions of factors predictive of impaired evolution. Our objective was to identify predictive factors of post-operative deterioration as well as outcomes at follow-up. METHODS: Between 2009 and 2016, 87 patients had surgery for spinal meningioma in our referral center. Clinical presentation, management and outcomes were reported during the post-operative period and at 3-month follow-up. Evaluation was based on post-operative neurological deterioration defined as an increase of at least one point in the McCormick score compared to the status at admission. RESULTS: During the study period, post-operative deterioration occurred in 17 patients (19.5%). Risk factors associated with this deterioration were the absence of pre-operative neurological signs (Relative Risk; RR = 2.38, p = 0.04), an anterior location of the meningioma and a grade 2 meningioma on WHO classification score (RR = 6, p ≤ 0.01). At 3-month follow-up, in patients who initially presented with a motor deficit, partial recovery was found in 75%, stability in 20% and a deterioration of their clinical status in 5%. After a mean follow-up of 92.4 ± 51.9 months, the recurrence rate was 8%. CONCLUSIONS:Spinal meningiomas are usually benign tumors whose treatment is based on complete surgical resection. Progress in surgical techniques has resulted in lower morbidity rates and improvement in post-operative recovery. In this study, we observed several factors associated with clinical deterioration. Before surgery, patients should be fully informed of these predictive factors of post-operative deterioration and their association with surgical morbidity.
Authors: A V Golanov; N A Konovalov; N A Antipina; E R Vetlova; S V Zolotova; M V Galkin; N V Arutyunov; А Yu Chamorsov; S A Krasnyanskiy; A G Nazarenko; D S Asyutin; S Yu Тimonin; V A Korolishin; R A Onoprienko Journal: Zh Vopr Neirokhir Im N N Burdenko Date: 2015
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