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Erratum. Thirty-day postoperative morbidity and mortality after temporal lobectomy for medically refractory epilepsy

Mohamad Bydon

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Erratum. Comparison of surgical interventions for the treatment of early-onset scoliosis: a systematic review and meta-analysis

Mohamad Bydon

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Erratum. Impact of predominant symptom location among patients undergoing cervical spine surgery on 12-month outcomes: an analysis from the Quality Outcomes Database

Mohamad Bydon

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Retraction. Immunohistochemical markers predicting recurrence following resection and radiotherapy in chordoma patients: insights from a multicenter study

Carlos Pinheiro Neto and Mohamad Bydon

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Erratum. Defining the minimum clinically important difference for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database

Mohamad Bydon and Jonathan R. Slotkin

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Editorial. Reflections on the first decade of neurosurgical science of practice: what has been accomplished; what ambitions remain to be fulfilled?

Anthony L. Asher, Mohamad Bydon, and Robert E. Harbaugh

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Introduction. Toward a contemporaneous understanding of cervical spondylotic myelopathy

Andrew K. Chan, Erica F. Bisson, Mohamad Bydon, and Praveen V. Mummaneni

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Editorial. Four-level anterior cervical discectomy and fusion: a cautionary tale

Mohamad Bydon, Erica F. Bisson, Andrew K. Chan, and Praveen V. Mummaneni

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Introduction. Predictive analytics in medicine

Anthony L. Asher, Clinton J. Devin, Robert E. Harbaugh, and Mohamad Bydon

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Trends in the utilization of radiotherapy for spinal meningiomas: insights from the 2004–2015 National Cancer Database

Yagiz Ugur Yolcu, Anshit Goyal, Mohammed Ali Alvi, FM Moinuddin, and Mohamad Bydon

OBJECTIVE

Recent studies have reported on the utility of radiosurgery for local control and symptom relief in spinal meningioma. The authors sought to evaluate national utilization trends in radiotherapy (including radiosurgery), investigate possible factors associated with its use in patients with spinal meningioma, and its impact on survival for atypical tumors.

METHODS

Using the ICD-O-3 topographical codes C70.1, C72.0, and C72.1 and histological codes 9530–9535 and 9537–9539, the authors queried the National Cancer Database for patients in whom spinal meningioma had been diagnosed between 2004 and 2015. Patients who had undergone radiation in addition to surgery and those who had received radiation as the only treatment were analyzed for factors associated with each treatment.

RESULTS

From among 10,458 patients with spinal meningioma in the database, the authors found a total of 268 patients who had received any type of radiation. The patients were divided into two main groups for the analysis of radiation alone (137 [51.1%]) and radiation plus surgery (131 [48.9%]). An age > 69 years (p < 0.001), male sex (p = 0.03), and tumor size 5 to < 6 cm (p < 0.001) were found to be associated with significantly higher odds of receiving radiation alone, whereas a Charlson-Deyo Comorbidity Index ≥ 2 (p = 0.01) was associated with significantly lower odds of receiving radiation alone. Moreover, a larger tumor size (2 to < 3 cm, p = 0.01; 3 to < 4 cm, p < 0.001; 4 to < 5 cm, p < 0.001; 5 to < 6 cm, p < 0.001; and ≥ 6 cm, p < 0.001; reference = 1 to < 2 cm), as well as borderline (p < 0.001) and malignant (p < 0.001) tumors were found to be associated with increased odds of undergoing radiation in addition to surgery. Receiving adjuvant radiation conferred a significant reduction in overall mortality among patients with borderline or malignant spinal meningiomas (HR 2.12, 95% CI 1.02–4.1, p = 0.02).

CONCLUSIONS

The current analysis of cases from a national cancer database revealed a small increase in the use of radiation for the management of spinal meningioma without a significant increase in overall survival. Larger tumor size and borderline or malignant behavior were found to be associated with increased radiation use. Data in the present analysis failed to show an overall survival benefit in utilizing adjuvant radiation for atypical tumors.