Department of Neurosurgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Normandie Univ, UNIROUEN, INSERM U1245, Laboratory of Microvascular Endothelium and Neonate Brain Lesions, 76000, Rouen, France.
J Neurooncol. 2018 Oct;140(1):49-54. doi: 10.1007/s11060-018-2929-y. Epub 2018 Jun 20.
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.
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.
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%.
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.
脊髓脑膜瘤是一种生长缓慢的硬脊膜外髓内肿瘤。它们通常预后良好。然而，关于预测预后不良的因素描述较少。我们的目的是确定术后恶化的预测因素以及随访时的结局。
在 2009 年至 2016 年期间，87 例患者在我们的转诊中心接受了脊髓脑膜瘤手术。报告了术后期间和 3 个月随访时的临床表现、治疗和结局。评估基于术后神经功能恶化，定义为与入院时相比 McCormick 评分至少增加 1 分。
在研究期间，17 例患者（19.5%）出现术后恶化。与这种恶化相关的危险因素包括术前无神经功能体征（相对风险；RR=2.38，p=0.04）、脑膜瘤位于前方和世界卫生组织（WHO）分级评分 2 级脑膜瘤（RR=6，p≤0.01）。在 3 个月随访时，在最初表现为运动功能缺损的患者中，75%部分恢复，20%稳定，5%临床状况恶化。平均随访 92.4±51.9 个月后，复发率为 8%。
脊髓脑膜瘤通常是良性肿瘤，其治疗基于完全手术切除。手术技术的进步降低了发病率，改善了术后恢复。在这项研究中，我们观察到了与临床恶化相关的几个因素。在手术前，应向患者充分告知这些术后恶化的预测因素及其与手术发病率的关系。
