Serratrice Nicolas, Lameche Imène, Attieh Christian, Chalah Moussa A, Faddoul Joe, Tarabay Bilal, Bou-Nassif Rabih, Ali Youssef, Mattar Joseph G, Nataf François, Ayache Samar S, Abi Lahoud Georges N
Institut de la Colonne Vertébrale et des Neurosciences (ICVNS), Centre Médico-Chirurgical Bizet, Paris, France.
EA 4391, Excitabilité Nerveuse et Thérapeutique, Faculté de Santé, Université Paris Est, Créteil, France.
Front Oncol. 2023 Jan 13;12:1084404. doi: 10.3389/fonc.2022.1084404. eCollection 2022.
Meningiomas arise from arachnoidal cap cells of the meninges, constituting the most common type of central nervous system tumors, and are considered benign tumors in most cases. Their incidence increases with age, and they mainly affect females, constituting 25-46% of primary spinal tumors. Spinal meningiomas could be detected incidentally or be unraveled by various neurological symptoms (, back pain, sphincter dysfunction, sensorimotor deficits). The gold standard diagnostic modality for spinal meningiomas is Magnetic resonance imaging (MRI) which permits their classification into four categories based on their radiological appearance. According to the World Health Organization (WHO) classification, the majority of spinal meningiomas are grade 1. Nevertheless, they can be of higher grade (grades 2 and 3) with atypical or malignant histology and a more aggressive course. To date, surgery is the best treatment where the big majority of meningiomas can be cured. Advances in surgical techniques (ultrasonic dissection, microsurgery, intraoperative monitoring) increase the complete resection rate. Operated patients have a satisfactory prognosis, even in those with poor preoperative neurological status. Adjuvant therapy has a growing role in treating spinal meningiomas, mainly in the case of subtotal resection and tumor recurrence. The current paper reviews the fundamental epidemiological and clinical aspects of spinal meningiomas, their histological and genetic characteristics, and their management, including the various surgical novelties and techniques.
脑膜瘤起源于脑膜的蛛网膜帽状细胞，是中枢神经系统肿瘤中最常见的类型，在大多数情况下被认为是良性肿瘤。其发病率随年龄增长而增加，主要影响女性，占原发性脊柱肿瘤的25% - 46%。脊髓脑膜瘤可偶然发现，也可由各种神经系统症状（如背痛、括约肌功能障碍、感觉运动障碍）揭示。脊髓脑膜瘤的金标准诊断方法是磁共振成像（MRI），它可根据其影像学表现将其分为四类。根据世界卫生组织（WHO）的分类，大多数脊髓脑膜瘤为1级。然而它们也可能是更高等级（2级和3级），具有非典型或恶性组织学特征以及更具侵袭性的病程。迄今为止，手术是最佳治疗方法，大多数脑膜瘤可通过手术治愈。手术技术（超声解剖、显微手术、术中监测）的进步提高了全切率。即使术前神经功能状态较差的患者，手术后也有令人满意的预后。辅助治疗在脊髓脑膜瘤的治疗中作用越来越大，主要用于次全切除和肿瘤复发的情况。本文综述了脊髓脑膜瘤的基本流行病学和临床方面、组织学和遗传学特征以及治疗方法，包括各种手术新进展和技术。
