Spinal meningiomas pose unique challenges based on the location of their dural attachment. However, there is a paucity of literature investigating the role of dural attachment location on outcomes after posterior-based approach for spinal meningioma resection. The aim of this study was to investigate any differences in outcomes between dural attachment location subgroups in spinal meningioma patients who underwent posterior-based resection.
This was a single-institution review of patients who underwent resection of a spinal meningioma from 1997 to 2017. Surgical, oncological, and neurological outcomes were compared between patients with varying dural attachments. Multivariate analysis was utilized.
A total of 141 patients were identified. The mean age was 62 years, and 110 women were included. The sites of dural attachments were as follows: 16 (11.3%) dorsal, 31 (22.0%) dorsolateral, 17 (12.1%) lateral, 40 (28.4%) ventral, and 37 (26.2%) ventrolateral. Most meningiomas were WHO grade I (92.2%) and in the thoracic spine (61.0%). All patients underwent a posterior approach for tumor resection. There were no differences between subgroups in terms of largest diameter of tumor resected (p = 0.201), gross-total resection (GTR) or subtotal resection (p = 0.362), Simpson grade of resection, perioperative complications (p = 0.116), long-term neurological deficit (p = 0.100), or postoperative radiation therapy (p = 0.971). Cervical spine location was associated with reduced incidence of GTR (OR 0.271, 95% CI 0.108–0.684, p = 0.006) on multivariate analysis. The overall incidence of recurrence/progression was 4.6%, with no difference (p = 0.800) between subgroups. Similarly, the average length of follow-up was 28.1 months, with no difference between subgroups (p = 0.413).
Posterior-based approaches for resection of spinal meningiomas are safe and effective, regardless of dural attachment location, with similar surgical, oncological, and neurological outcomes. Comparison of long-term recurrence rates between dural attachment subgroups is required.
AP = anteroposterior; GTR = gross-total resection; LOS = length of stay; ML = mediolateral; SI = superoinferior; STR = subtotal resection.
INCLUDE WHEN CITING Published online September 23, 2022; DOI: 10.3171/2022.7.SPINE211603.
Disclosures Dr. Tan is a consultant for Medtronic, Stryker, and Accelus. Dr. Clark is a consultant for NuVasive. Dr. Chou is a consultant for Globus and Orthofix. Dr. Mummaneni is a consultant for DePuy Synthes, Globus, and Stryker; owns stock in Spinicity/ISD; receives non–study-related clinical or research support from AO Spine, NREF, ISSG, and NIH; and receives royalties from DePuy Synthes, Thieme Publishers, and Springer Publishers. Dr. Ames receives royalties from Stryker, Biomet Zimmer Spine, NuVasive, Next Orthosurgical, K2M, Medicrea, and DePuy Synthes; is a consultant for DePuy Synthes, Medtronic, Medicrea, K2M, Agada Medical, and Carlsmed; receives research support from Titan Spine, DePuy Synthes, and ISSG; serves on the editorial board of Operative Neurosurgery; receives grant funding from SRS; serves on the executive committee of ISSG; is the director of Global Spinal Analytics; and is chair of the SRS Safety and Value Committee.
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