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Spinal meningioma and factors predictive of post-operative deterioration

Abstract : PURPOSE: 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. METHODS: 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. RESULTS: 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%. CONCLUSIONS: 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.
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Submitted on : Tuesday, December 10, 2019 - 3:09:29 PM
Last modification on : Thursday, July 2, 2020 - 3:42:12 AM




Vianney Gilard, Alice Goia, François-Xavier Ferracci, Florent Marguet, Nicolas Magné, et al.. Spinal meningioma and factors predictive of post-operative deterioration. Journal of Neuro-Oncology, Springer Verlag, 2018, 140 (1), pp.49-54. ⟨10.1007/s11060-018-2929-y⟩. ⟨hal-02402574⟩



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