Highlights
- •Patients’ age is not associated with tumor location or volume in spinal meningiomas.
- •Risk of preoperative motor and sensory deficits rises with age at diagnosis.
- •Surgical procedures do not correlate with patients’ age.
- •Non-neurological complications are common in elderly patients.
- •Increasing age is associated with postoperative symptom improvement.
Abstract
Although the majority of surgeries for spinal meningiomas are performed in geriatric
patients, age-related analyzes of preoperative symptoms and functional outcome are
sparse. Clinical, neuropathological and radiological data of 88 patients who underwent
surgery for spinal meningiomas were reviewed. Correlations between the patients’ age
and preoperative symptoms as well as functional outcome were investigated. 14 males
(16%) and 74 females (84%) with a median age of 67 years were included. Age at the
time of surgery was independent of the tumor location and volume, intra-/extradural
tumor location, spinal cord compression or signal change on T2-weighted MRI (p > 0.05,
each). Preoperative McCormick score (p = 0.001), motor (p = 0.005) and sensory (p = 0.025)
deficits and incontinence (p = 0.010) increased, while frequency of radicular pain
decreased with increasing age (p = 0.020). Multivariate analyses confirmed an increasing
risk of motor (OR: 1.05, p = 0.017) and, with borderline significance, of sensory
deficits (OR: 1.04, 95%CI 1.00–1.10; p = 0.056) with rising age. Simpson grades I,
II, III and IV were achieved in 12 (14%), 54 (64%), 14 (17%) and 4 (5%) individuals,
respectively. Only 3 of 12 patients (25%) with perioperative complications were younger
than 65 years. Rising age was associated with improvement of motor (p = 0.006) and
sensory deficits (p = 0.045). In multivariate analyzes, probability of improvement
of preoperative motor weakness (OR = 1.05, p = 0.031) and sensory deficits (OR = 1.07,
p = 0.014) increased with rising age. Despite more frequent preoperative neurological
deficits, older patients with spinal meningiomas recover most noticeably after surgery.
However, stratification of the medical condition is urgent to reduce complications.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Clinical NeuroscienceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Long-term surgical outcomes of spinal meningiomas.Spine (Phila Pa 1976). 2012; 37: E617-E623https://doi.org/10.1097/BRS.0b013e31824167f1
- Management of spinal meningiomas: surgical results and a review of the literature.Neurosurg Focus. 2007; 23: E14https://doi.org/10.3171/FOC-07/10/E14
- Spinal meningiomas: critical review of 131 surgically treated patients.Eur Spine J. 2008; 17: 1035-1041https://doi.org/10.1007/s00586-008-0685-y
- Spinal meningioma: relationship between histological subtypes and surgical outcome?.J Neurooncol. 2005; 75: 157-161https://doi.org/10.1007/s11060-005-1469-4
- Complication avoidance in the resection of spinal meningiomas.World Neurosurg. 2015; 83: 627-634https://doi.org/10.1016/j.wneu.2014.12.015
- Minimally invasive surgery for benign intradural extramedullary spinal meningiomas: experience of a single institution in a cohort of elderly patients and review of the literature.Clin Interv Aging. 2012; 7: 557-564https://doi.org/10.2147/CIA.S38923
- Descriptive epidemiology of spinal meningiomas in the United States.Spine (Phila Pa 1976). 2015; 40: E886-E889https://doi.org/10.1097/BRS.0000000000000974
- Spinal meningioma: chronicles of contemporary neurosurgical diagnosis and management.Clin Neurol Neurosurg. 2009; 111: 221-226https://doi.org/10.1016/j.clineuro.2008.10.018
- Complications and outcomes of surgery for spinal meningioma: a Nationwide Inpatient Sample analysis from 2003 to 2010.Clin Neurol Neurosurg. 2014; 118: 65-68https://doi.org/10.1016/j.clineuro.2013.12.010
- Surgery for meningioma in the elderly and long-term survival: comparison with an age- and sex-matched general population and with younger patients.J Neurosurg. 2016; : 1-11https://doi.org/10.3171/2016.2.JNS152611
- Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome.Acta Neurochir (Wien). 2015; 157 (discussion 1557): 1549-1557https://doi.org/10.1007/s00701-015-2502-9
- Outcome comparison between younger and older patients undergoing intracranial meningioma resections.J Neurooncol. 2013; 114: 219-227https://doi.org/10.1007/s11060-013-1173-8
- Outcome of elderly patients undergoing intracranial meningioma resection–a systematic review and meta-analysis.Br J Neurosurg. 2014; 28: 303-309https://doi.org/10.3109/02688697.2013.841857
- Intraspinal meningioma in a 101-year old: should age determine the aggressiveness of intervention?.Surg Neurol. 2008; 69: 130-134https://doi.org/10.1016/j.surneu.2007.01.041
- Meningiomas.in: Louis D.N. Ohgaki H. Wiestler O.D. Cavenee W.K. Ellison D.W. Figarella-Branger D. Perry A. Reifenberger G. von Deimlig A. WHO Classification of Tumors of the Central Nervous System. International Agency on Cancer Research, Lyon2016: 232-245
- Assessment of outcome in patients undergoing surgery for intradural spinal tumor using the multidimensional patient-rated Core Outcome Measures Index and the modified McCormick Scale.Neurosurg Focus. 2015; 39: E2https://doi.org/10.3171/2015.5.FOCUS15163
- The recurrence of intracranial meningiomas after surgical treatment.J Neurol Neurosurg Psychiatry. 1957; 20: 22-39
- Brain invasion and the risk of seizures in patients with meningioma.J Neurosurg. 2018; : 1-8https://doi.org/10.3171/2017.11.JNS172265
- Spinal meningiomas: age-related features.Clin Neurol Neurosurg. 2011; 113: 34-38https://doi.org/10.1016/j.clineuro.2010.08.017
- Spinal meningioma surgery in elderly patients with paraplegia or severe paraparesis: a multicenter study.Neurosurgery. 2009; 64: 503-509https://doi.org/10.1227/01.NEU.0000338427.44471.1D
- Treatment and survival of patients with nonmalignant intracranial meningioma: results from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.Clinical article. J Neurosurg. 2011; 115: 259-267https://doi.org/10.3171/2011.3.JNS101748
- Surgery for intracranial meningiomas in the elderly: a clinical-radiological grading system as a predictor of outcome.J Neurosurg. 2005; 102: 290-294https://doi.org/10.3171/jns.2005.102.2.0290
- Meningiomas in the elderly, the surgical benefit and a new scoring system.Acta Neurochir (Wien). 2010; 152: 87-97https://doi.org/10.1007/s00701-009-0552-6
- A less invasive surgical concept for the resection of spinal meningiomas.Acta Neurochir (Wien). 2008; 150: 551-556https://doi.org/10.1007/s00701-008-1514-0
- Factors leading to a poor functional outcome in spinal meningioma surgery: Remarks on 173 Cases.Neurosurgery. 2017; 80: 602-609https://doi.org/10.1093/neuros/nyw092
- Spinal meningiomas: a 20-year review.Br J Neurosurg. 1998; 12: 521-526
- Results in the operative treatment of elderly patients with spinal meningiomas.Spine (Phila Pa 1976). 2004; 29: 2191-2194
- Intraoperative neurophysiological monitoring in spine surgery: indications, efficacy, and role of the preoperative checklist.Neurosurg Focus. 2012; 33: E10https://doi.org/10.3171/2012.9.FOCUS12235
- Keyhole approaches to intradural pathologies.Neurosurg Focus. 2017; 43: E5https://doi.org/10.3171/2017.5.FOCUS17198
- Does histologic subtype influence the post-operative outcome in spinal meningioma?.Iran J Cancer Prev. 2016; 9e3838https://doi.org/10.17795/ijcp-3838
- Spinal meningiomas: clinicoradiological factors predicting recurrence and functional outcome.Neurosurg Focus. 2016; 41: E6https://doi.org/10.3171/2016.5.FOCUS16163
Article info
Publication history
Published online: August 22, 2018
Accepted:
August 13,
2018
Received:
May 8,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
