Long-term surgical outcomes of spinal meningiomas

Masaya Nakamura, Osahiko Tsuji, Kanehiro Fujiyoshi, Naobumi Hosogane, Kota Watanabe, Takashi Tsuji, Ken Ishii, Yoshiaki Toyama, Kazuhiro Chiba, Morio Matsumoto

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STUDY DESIGN.: Retrospective case series. OBJECTIVE.: To evaluate the treatment strategies for spinal meningioma. SUMMARY OF BACKGROUND DATA.: Although previous studies have demonstrated favorable surgical outcomes for spinal meningioma, with a low incidence of tumor recurrence, few have examined long-term surgical outcomes. METHODS.: The influence of patient age, surgical margin status (Simpson grade), tumor location, and histological subtype on tumor recurrence were examined retrospectively. In addition, the resected dura mater from Simpson grade I cases was examined for invasive tumor cells and compared with the presence or absence of a dural tail sign on magnetic resonance image. RESULTS.: Complete resection (Simpson grades I and II) was performed in 62 patients. Among them, the tumor recurrence rate was 9.7%, all in patients who underwent grade II resection for ventral spinal lesions. The mean duration to reoperation in these patients was 12.2 ± 5.2 years. Of the 6 patients who underwent incomplete resection (Simpson grade III/IV), all required reoperation for tumor recurrence or regrowth, 5 years later on average. Patients younger than 50 years at the initial surgery had a significantly higher recurrence rate than those aged 50 years or older. Histologic examination of 43 dura mater specimens from Simpson grade I-resection patients revealed tumor cell invasion between the inner and outer layers in 15 patients. This invasion was noted in 8 (29%) of 28 patients who were negative for the dural tail sign on magnetic resonance image, and in 7 (47%) of 15 patients who showed a positive dural tail sign. The MIB-1 index reached about 10% for dumbbell-type meningiomas invading the vertebral body; these were associated with repeated recurrence and unfavorable prognosis. CONCLUSION.: Long-term follow-up after surgery for meningiomas indicated that Simpson grade I resection should be selected whenever practicable when treating younger patients or dumbbell-type meningiomas. Tumors recurred at 12 years, on average, in approximately 30% of patients who underwent grade II resection.

Original languageEnglish
Pages (from-to)E617-E623
Issue number10
Publication statusPublished - 2012 May 1


  • meningioma
  • pinal cord
  • recurrence
  • surgical outcome

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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    Nakamura, M., Tsuji, O., Fujiyoshi, K., Hosogane, N., Watanabe, K., Tsuji, T., Ishii, K., Toyama, Y., Chiba, K., & Matsumoto, M. (2012). Long-term surgical outcomes of spinal meningiomas. Spine, 37(10), E617-E623. https://doi.org/10.1097/BRS.0b013e31824167f1