scholarly journals Differences and characteristics of symptoms by tumor location, size, and degree of spinal cord compression: a retrospective study on 53 surgically treated, symptomatic spinal meningiomas

2020 ◽  
Vol 32 (6) ◽  
pp. 931-940
Author(s):  
Satoshi Yamaguchi ◽  
Arnold H. Menezes ◽  
Kiyoharu Shimizu ◽  
Royce W. Woodroffe ◽  
Logan C. Helland ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Retrospective Study ◽  
Spinal Cord Compression ◽  
Tumor Location ◽  
Cord Compression ◽  
Sensory Disturbance ◽  
Mr Images ◽  
Spinal Level ◽  
Motor Weakness ◽  
Spinal Meningiomas

OBJECTIVEThe differences in symptoms of spinal meningiomas have rarely been discussed from the perspective of tumor characteristics. The main purpose of this paper was to define the differences, if any, in symptoms in patients with spinal meningiomas with respect to tumor size, location, and degree of spinal cord compression. The authors also sought the threshold of spinal cord compression that causes motor weakness.METHODSThe authors conducted a retrospective study of 53 cases of spinal meningiomas that were surgically treated from 2013 to 2018. Symptoms related to the tumor were classified as motor weakness, sensory disturbance, pain, and bowel/bladder dysfunction. Based on MR images, tumor location was classified by spinal level and by its attachment to the dura mater. Tumor dimensions were also measured. Occupation ratios of the tumors to the spinal canal and degree of spinal cord flattening were sought from the axial MR images that showed the highest degree of spinal cord compression.RESULTSMotor weakness and sensory disturbance were significantly more common in thoracic spine meningiomas than in cervical spine meningiomas (p < 0.001 and p = 0.013, respectively), while pain was more common in meningiomas at the craniovertebral junction (p < 0.001). The attachment, height, width, depth, and volume of the tumor showed no significant difference irrespective of the presence or absence of each symptom. In cases of motor weakness and sensory disturbance, occupation ratios and spinal cord flattening ratios were significantly larger. However, these ratios were significantly smaller in the presence of pain. Multivariate logistic regression analysis revealed that occupation ratio independently contributed to motor weakness (OR 1.14, p = 0.035) and pain (OR 0.925, p = 0.034). Receiver operating characteristic curve analysis suggested that occupation ratio with a value of 63.678% is the threshold for the tumor to cause motor weakness.CONCLUSIONSThe study showed the difference in clinical presentation of spinal meningiomas by spinal level, occupation ratio, and spinal cord flattening ratio. An occupation ratio of approximately 64% could be utilized as the threshold value of tumor growth to cause motor weakness. Tumor growth in the cervical spine might cause pain symptoms before causing motor weakness. The relationship between the tumor and its symptomatology should be discussed with respect to tumor size relative to the surrounding spinal canal.

scholarly journals Long-Term Follow-Up and Predictors of Functional Outcome after Surgery for Spinal Meningiomas: A Population-Based Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3244
Author(s):  
Jenny Pettersson-Segerlind ◽  
Alexander Fletcher-Sandersjöö ◽  
Charles Tatter ◽  
Gustav Burström ◽  
Oscar Persson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Magnetic Resonance Images ◽  
Motor Deficit ◽  
Tumor Control ◽  
Time To Surgery ◽  
Spinal Meningiomas

Spinal meningiomas are the most common adult primary spinal tumor, constituting 24–45% of spinal intradural tumors and 2% of all meningiomas. The aim of this study was to assess postoperative complications, long-term outcomes, predictors of functional improvement and differences between elderly (≥70 years) and non-elderly (18–69 years) patients surgically treated for spinal meningiomas. Variables were retrospectively collected from patient charts and magnetic resonance images. Baseline comparisons, paired testing and regression analyses were used. In conclusion, 129 patients were included, with a median follow-up time of 8.2 years. Motor deficit was the most common presenting symptom (66%). The median time between diagnosis and surgery was 1.3 months. A postoperative complication occurred in 10 (7.8%) and tumor growth or recurrence in 6 (4.7%) patients. Surgery was associated with significant improvement of motor and sensory deficit, gait disturbance, bladder dysfunction and pain. Time to surgery, tumor area and the degree of spinal cord compression significantly predicted postoperative improvement in a modified McCormick scale (mMCs) in the univariable regression analysis, and spinal cord compression showed independent risk association in multivariable analysis. There was no difference in improvement, complications or tumor control between elderly and non-elderly patients. We concluded that surgery of spinal meningiomas was associated with significant long-term neurological improvement, which could be predicted by time to surgery, tumor size and spinal cord compression.

scholarly journals Cervical Cord Compression With Lower Limbs Sensory Disturbance Presentation: Three Case Reports and Literature Review

2021 ◽  
Author(s):  
Yafei Cao ◽  
Yihong Wu ◽  
Weiji Yu ◽  
Weidong Liu ◽  
Shufen Sun ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Lower Limb ◽  
Cord Compression ◽  
Lower Limbs ◽  
Anterior Cervical Discectomy ◽  
Cervical Cord ◽  
Sensory Disturbance ◽  
Cervical Discectomy ◽  
Sensory Disturbances

Abstract Background: Lower limb sensory disturbance presentation can be a false localizing cervical cord compressive myelopathy (CSM). It may lead to delayed or missed diagnosis, resulting in the wrong management plan, especially in the presence of concurrent lumbar lesions.Case presentation:Three Asian patients with lower limb sensory disturbances presentation were treated ineffectively in the lumbar. Magnetic resonance imaging (MRI) showed cervical disc herniation and cervical level spinal cord compression. Anterior cervical discectomy surgery and zero-p interbody fusion were performed. After operations, imagings showed that the spinal cord compression were relieved, and the lower limbs sensory disturbances were also relieved. Three-months follow-up after operation showed good recovery.Conclusions:These three cervical cord compression cases of lower limb sensory disturbance presentation were easily misdiagnosed with lumbar spondylosis. Anterior cervical discectomy and fusion operation had a good therapeutic effect. Therefore, cases that present with lower limb sensory disturbance, but in a non-radicular classical pattern, should always alert a suspicion of a possible cord compression cause at a higher level.

scholarly journals A retrospective study of delays in diagnosis and treatment for malignant spinal cord compression

2015 ◽  
Vol 10 (3) ◽  
pp. 305-309 ◽  
Author(s):  
Chieko Kudo ◽  
Tomohiko Niitani ◽  
Hitoshi Wada ◽  
Yuko Sato ◽  
Sonoko Ichikawa ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Retrospective Study ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Diagnosis And Treatment ◽  
Delays In Diagnosis

Contrast radiographic findings in canine bacterial discospondylitis: a multicenter, retrospective study of 27 cases

2000 ◽  
Vol 36 (1) ◽  
pp. 81-85 ◽  
Author(s):  
MJ Davis ◽  
CW Dewey ◽  
MA Walker ◽  
SC Kerwin ◽  
ML Moon ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Retrospective Study ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Neurological Dysfunction ◽  
Anatomical Site ◽  
Significant Component ◽  
Radiographic Findings ◽  
Ultimate Outcome ◽  
Vertebral Subluxation

A multicenter, retrospective study was undertaken to evaluate contrast radiographic findings in canine bacterial discospondylitis. Records and myelograms or epidurograms of 27 patients were obtained from five colleges of veterinary medicine. Fifteen cases (56%) were evaluated as having some degree of spinal cord compression. The majority (73.3%) of the cases had only soft tissue as the compressive mass. The median compression for all cases was 5% of the vertebral canal. No difference was noted for compression based on anatomical site (i.e., cervical versus thoracolumbar versus lumbosacral). No significant correlation between degree of lesion compression and clinical outcome was noted, but there was a trend toward increased mortality with greater compression. There was no correlation between the ambulatory status and the ultimate outcome. Three of the 15 (20%) cases showed vertebral subluxation. Results of this study indicate that static spinal cord compression is not a significant component of the neurological dysfunction associated with bacterial discospondylitis. Identification of vertebral subluxation in some patients may indicate a dynamic lesion that should be evaluated with stress radiography.

Reliability analysis of the epidural spinal cord compression scale

2010 ◽  
Vol 13 (3) ◽  
pp. 324-328 ◽  
Author(s):  
Mark H. Bilsky ◽  
Ilya Laufer ◽  
Daryl R. Fourney ◽  
Michael Groff ◽  
Meic H. Schmidt ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Imaging Techniques ◽  
Spinal Metastases ◽  
Cord Compression ◽  
Spinal Tumors ◽  
Mr Images ◽  
Intrarater Reliability ◽  
Thoracic Spinal ◽  
Sagittal Image

Objective The evolution of imaging techniques, along with highly effective radiation options has changed the way metastatic epidural tumors are treated. While high-grade epidural spinal cord compression (ESCC) frequently serves as an indication for surgical decompression, no consensus exists in the literature about the precise definition of this term. The advancement of the treatment paradigms in patients with metastatic tumors for the spine requires a clear grading scheme of ESCC. The degree of ESCC often serves as a major determinant in the decision to operate or irradiate. The purpose of this study was to determine the reliability and validity of a 6-point, MR imaging–based grading system for ESCC. Methods To determine the reliability of the grading scale, a survey was distributed to 7 spine surgeons who participate in the Spine Oncology Study Group. The MR images of 25 cervical or thoracic spinal tumors were distributed consisting of 1 sagittal image and 3 axial images at the identical level including T1-weighted, T2-weighted, and Gd-enhanced T1-weighted images. The survey was administered 3 times at 2-week intervals. The inter- and intrarater reliability was assessed. Results The inter- and intrarater reliability ranged from good to excellent when surgeons were asked to rate the degree of spinal cord compression using T2-weighted axial images. The T2-weighted images were superior indicators of ESCC compared with T1-weighted images with and without Gd. Conclusions The ESCC scale provides a valid and reliable instrument that may be used to describe the degree of ESCC based on T2-weighted MR images. This scale accounts for recent advances in the treatment of spinal metastases and may be used to provide an ESCC classification scheme for multicenter clinical trial and outcome studies.

scholarly journals Spinal cord compression in relation to clinical symptoms in patients with spinal meningiomas

2021 ◽  
Vol 1 ◽  
pp. 100464
Author(s):  
A. Corell ◽  
C. Cerbach ◽  
N. Hoefling ◽  
I.M. Björkman-Burtscher ◽  
A.S. Jakola
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Clinical Symptoms ◽  
Cord Compression ◽  
Spinal Meningiomas

scholarly journals Spinal cord compression in relation to clinical symptoms in patients with spinal meningiomas

2021 ◽  
pp. 107018
Author(s):  
Alba Corell ◽  
Charlotte Cerbach ◽  
Nickoleta Hoefling ◽  
Isabella M. Björkman-Burtscher ◽  
Asgeir Store Jakola
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Clinical Symptoms ◽  
Cord Compression ◽  
Spinal Meningiomas

scholarly journals Spinal cord compression in small cell lung cancer: a retrospective study of 610 patients

1989 ◽  
Vol 59 (4) ◽  
pp. 591-593 ◽  
Author(s):  
JM Goldman ◽  
CM Ash ◽  
RL Souhami ◽  
DM Geddes ◽  
PG Harper ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Spinal Cord ◽  
Retrospective Study ◽  
Small Cell Lung Cancer ◽  
Spinal Cord Compression ◽  
Cell Lung Cancer ◽  
Cord Compression ◽  
Small Cell ◽  
Small Cell Lung

scholarly journals A Rare Case of Extra Dural Dorsal Meningioma; Case Report and Analytique Review of Literature about 77 Cases

2021 ◽  
Vol 6 (05) ◽  
pp. 341-350
Author(s):  
Niamien Patrice Koffi ◽  
Mohcine Salami ◽  
Inas Elkacemi ◽  
Gazzaz Miloudi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Dorsal Spinal Cord ◽  
Female Predominance ◽  
Analytical Review ◽  
Spinal Meningiomas ◽  
Grade 3 ◽  
The Right

Spinal meningiomas are usually intra dural tumors, the purely extra dural localization is exceptional, they are easily mistaken for malignant tumor resulting in inadequate management. Only 77 cases have been reported in the literature. Less than 28 cases have been confirmed after durotomy since 1898. We report a new observation followed by an analytical review of the literature with a study of the socio-epidemiological, radiological parameters and of the neurosurgical and progressive management of extra dural spinal meningiomas. Observation: a 57-year-old, female patient with no medical history was admitted to our training for slow dorsal spinal cord compression progression since 06 months. Neurological examination found FRANKEL stage C paraplegia, higher level D7 hypoaesthesia without sphincter disorders. The medullary MRI objectified an intraspinal process of 1.5x2x1cm, well limited, of the right posterolateral of D8-D9 causing compression of the dorsal cord with an intramedullary hyper signal in T2. The D8-D9 laminectomy was performed. Surgical exploration found an extra dural lesion without intra dural extension. The excision was macroscopically complete. Histological examination was in favor of a benign meninigothelial. The post-operative course was marked by a partial and progressive recovery of the neurological deficit and no recurrence. Discussion: the retrospective analysis of literature about 49 publications was founded that, the incidence in 1933 by Elsberg was 5.5%, Haft in 1963 found 3.5%. In 2020 our study found 3.46% of all spine meningioma. The mean age is 44.19 years [8 years -85 years] with a female predominance of 2/1. The mode of revelation is in 11.53% of fortuitous discovery, in 59.93% by the high state of spinal cord compression stage C of FRANKEL. The topography is dorsal = 51.31%, cervical = 44.76%. MRI scan has been use since 1996 at 67.60%. Laminectomy was performed in 71.79% with durotomy in 11%. The excision is complete with SIMPSON I in 70% and SYMPSON III in 27%. The predominant histological is a grade 1 of meningioma = 73.41%, grade 2 = 6.32%, grade 3 = 1.26% in 19 % meningioma was not specified by the authors. Conclusion: The prognosis of extra dural spinal meningiomas according to our study is good overall with only 3 cases of recurrence of spinal meningioma in 36 patients, or 8.33% after a mean follow-up of 31.59 months [1 -168 months] with P=0,012.

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