Spinal Meningiomas: Influence of Cord Compression and Radiological Features on Preoperative Functional Status and Outcome
Background: Radiological parameters predicting the postoperative neurological outcome after resection of a spinal meningioma (SM) are poorly studied, with controversial results. Methods: Observational multicenter cohort (2011–2018) of adult patients undergoing surgery for resection of SM. Tumor-cana...
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doaj-106bfdd73989401dbe074ed255e23cc52021-08-26T13:36:06ZengMDPI AGCancers2072-66942021-08-01134183418310.3390/cancers13164183Spinal Meningiomas: Influence of Cord Compression and Radiological Features on Preoperative Functional Status and OutcomeValentina Baro0Alessandro Moiraghi1Valentina Carlucci2Luca Paun3Mariagiulia Anglani4Mario Ermani5Andrea Saladino6Franco Chioffi7Domenico d’Avella8Andrea Landi9Andrea Bartoli10Francesco DiMeco11Karl Schaller12Luca Denaro13Enrico Tessitore14Academic Neurosurgery, Department of Neurosciences, University of Padova, 35128 Padova, ItalyDepartment of Neurosurgery, GHU Paris-Sainte-Anne Hospital, 75014 Paris, FranceDivision of Neurology, Department of Neurosciences, University of Padova, 35128 Padova, ItalyDivision of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva, SwitzerlandNeuroradiology Unit, Azienda Ospedaliera Università di Padova, 35128 Padova, ItalyDepartment of Neurosciences, University of Padova, 35128 Padova, ItalyNeurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale “C. Besta”, 20133 Milan, ItalyDivision of Neurosurgery, Azienda Ospedaliera Università di Padova, 35128 Padova, ItalyAcademic Neurosurgery, Department of Neurosciences, University of Padova, 35128 Padova, ItalyAcademic Neurosurgery, Department of Neurosciences, University of Padova, 35128 Padova, ItalyDivision of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva, SwitzerlandNeurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale “C. Besta”, 20133 Milan, ItalyDivision of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva, SwitzerlandAcademic Neurosurgery, Department of Neurosciences, University of Padova, 35128 Padova, ItalyDivision of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva, SwitzerlandBackground: Radiological parameters predicting the postoperative neurological outcome after resection of a spinal meningioma (SM) are poorly studied, with controversial results. Methods: Observational multicenter cohort (2011–2018) of adult patients undergoing surgery for resection of SM. Tumor-canal volume ratio (TCR), the areas related to the cord and tumor occupancy at maximum compression, the presence of dural tail, calcifications, signs of myelopathy, and postoperative cord expansion were compared with the modified McCormick scale (mMCS) preoperative and at follow-up. Results: In the cohort (<i>n</i> = 90 patients), cord and tumor occupancy as well as cord compression and tumor volume showed a correlation with preoperative mMCS (<i>p</i> < 0.05, R −0.23; <i>p</i> < 0.001, R 0.35; <i>p</i> < 0.005, R −0.29; <i>p</i> < 0.001, R 0.42). Cord occupancy had a strong correlation with cord compression (<i>p</i> < 0.001, R 0.72). Tumor occupancy and TCR were correlated with relative outcome at follow-up (<i>p</i> < 0.005 R 0.3; <i>p</i> < 0.005 R 0.29). No correlation was found between cord re-expansion and clinical outcome at follow-up. Finally, a correlation was shown between preoperative signs of cord myelopathy and mMCS (<i>p</i> < 0.05 R 0.21) at follow-up. Conclusions: Larger tumors showed lower preoperative functional status and a worse clinical outcome. Moreover, preoperative T2 cord signal changes are correlated with a poorer outcome.https://www.mdpi.com/2072-6694/13/16/4183spinal meningiomacord compressionfunctional outcomeMcCormick scalemagnetic resonance imagingtumor volume |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Valentina Baro Alessandro Moiraghi Valentina Carlucci Luca Paun Mariagiulia Anglani Mario Ermani Andrea Saladino Franco Chioffi Domenico d’Avella Andrea Landi Andrea Bartoli Francesco DiMeco Karl Schaller Luca Denaro Enrico Tessitore |
spellingShingle |
Valentina Baro Alessandro Moiraghi Valentina Carlucci Luca Paun Mariagiulia Anglani Mario Ermani Andrea Saladino Franco Chioffi Domenico d’Avella Andrea Landi Andrea Bartoli Francesco DiMeco Karl Schaller Luca Denaro Enrico Tessitore Spinal Meningiomas: Influence of Cord Compression and Radiological Features on Preoperative Functional Status and Outcome Cancers spinal meningioma cord compression functional outcome McCormick scale magnetic resonance imaging tumor volume |
author_facet |
Valentina Baro Alessandro Moiraghi Valentina Carlucci Luca Paun Mariagiulia Anglani Mario Ermani Andrea Saladino Franco Chioffi Domenico d’Avella Andrea Landi Andrea Bartoli Francesco DiMeco Karl Schaller Luca Denaro Enrico Tessitore |
author_sort |
Valentina Baro |
title |
Spinal Meningiomas: Influence of Cord Compression and Radiological Features on Preoperative Functional Status and Outcome |
title_short |
Spinal Meningiomas: Influence of Cord Compression and Radiological Features on Preoperative Functional Status and Outcome |
title_full |
Spinal Meningiomas: Influence of Cord Compression and Radiological Features on Preoperative Functional Status and Outcome |
title_fullStr |
Spinal Meningiomas: Influence of Cord Compression and Radiological Features on Preoperative Functional Status and Outcome |
title_full_unstemmed |
Spinal Meningiomas: Influence of Cord Compression and Radiological Features on Preoperative Functional Status and Outcome |
title_sort |
spinal meningiomas: influence of cord compression and radiological features on preoperative functional status and outcome |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2021-08-01 |
description |
Background: Radiological parameters predicting the postoperative neurological outcome after resection of a spinal meningioma (SM) are poorly studied, with controversial results. Methods: Observational multicenter cohort (2011–2018) of adult patients undergoing surgery for resection of SM. Tumor-canal volume ratio (TCR), the areas related to the cord and tumor occupancy at maximum compression, the presence of dural tail, calcifications, signs of myelopathy, and postoperative cord expansion were compared with the modified McCormick scale (mMCS) preoperative and at follow-up. Results: In the cohort (<i>n</i> = 90 patients), cord and tumor occupancy as well as cord compression and tumor volume showed a correlation with preoperative mMCS (<i>p</i> < 0.05, R −0.23; <i>p</i> < 0.001, R 0.35; <i>p</i> < 0.005, R −0.29; <i>p</i> < 0.001, R 0.42). Cord occupancy had a strong correlation with cord compression (<i>p</i> < 0.001, R 0.72). Tumor occupancy and TCR were correlated with relative outcome at follow-up (<i>p</i> < 0.005 R 0.3; <i>p</i> < 0.005 R 0.29). No correlation was found between cord re-expansion and clinical outcome at follow-up. Finally, a correlation was shown between preoperative signs of cord myelopathy and mMCS (<i>p</i> < 0.05 R 0.21) at follow-up. Conclusions: Larger tumors showed lower preoperative functional status and a worse clinical outcome. Moreover, preoperative T2 cord signal changes are correlated with a poorer outcome. |
topic |
spinal meningioma cord compression functional outcome McCormick scale magnetic resonance imaging tumor volume |
url |
https://www.mdpi.com/2072-6694/13/16/4183 |
work_keys_str_mv |
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