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The entity of cord compression as a predictor of outcome in spinal meningiomas surgery: preliminary results of a retrospective multicentric study
EANS Academy. Moiraghi A. 09/26/19; 276108; EP04139
Dr. Alessandro Moiraghi
Dr. Alessandro Moiraghi

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Abstract
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Background: After spinal meningioma surgery most of patients exhibit an excellent postoperative functional outcome despite tumour dimensions and severity of cord compression. We report our preliminary results concerning the relations between cord compression, preoperative neurological status and postoperative outcome.
Methods: We retrospectively analysed 37 patients who underwent spinal meningioma removal between 2011-2018. Preoperative and postoperative functional status were measured according to mMcCormick scale. Preoperative MRI were analysed to calculate the ratio between tumour and spinal canal volumes, the percentage of tumour occupancy, cord occupancy and the cord area at maximum compression. Postoperative follow-up MRI were evaluated to estimate the percentage of cord expansion at the level of preoperative maximum compression. These values were then compared with preoperative and postoperative outcomes measures.
Results: 29 patients were female (ratio 1:3.6), 29 (78.4%) had thoracic meningiomas, 6 (16.2%) cervical meningiomas, 1 (2.7%) cervico-thoracic and 1 (2.7%) a thoraco-lumbar lesion. Mean age was 66.5 years (range 8-85) and the mean follow-up was 27.7 months (range 4-75). Mean preoperative and postoperative mMcCormick grade was 2.2 and 1.4 respectively, mean relative postoperative outcome was 28.6%. The average tumour volume was 55.4% of the spinal canal. The average remaining cord cross-sectional area was 67.7% of the estimated original value. The average tumour occupancy at maximum compression was 71.4%, the average cord occupancy at the same level was 20.8%. No correlation was seen between these values with preoperative and postoperative mMcCormick grade. On follow-up MRI the average cord area had increased to 91.6% without correlation with outcome.
Conclusion: Notwithstanding the important degree of cord compression we did not find a relationship between radiological measurements with neurological function before or after surgery, disclosing the complexity and the concurrence of still unknown factors in spinal cord functional recovery.
Background: After spinal meningioma surgery most of patients exhibit an excellent postoperative functional outcome despite tumour dimensions and severity of cord compression. We report our preliminary results concerning the relations between cord compression, preoperative neurological status and postoperative outcome.
Methods: We retrospectively analysed 37 patients who underwent spinal meningioma removal between 2011-2018. Preoperative and postoperative functional status were measured according to mMcCormick scale. Preoperative MRI were analysed to calculate the ratio between tumour and spinal canal volumes, the percentage of tumour occupancy, cord occupancy and the cord area at maximum compression. Postoperative follow-up MRI were evaluated to estimate the percentage of cord expansion at the level of preoperative maximum compression. These values were then compared with preoperative and postoperative outcomes measures.
Results: 29 patients were female (ratio 1:3.6), 29 (78.4%) had thoracic meningiomas, 6 (16.2%) cervical meningiomas, 1 (2.7%) cervico-thoracic and 1 (2.7%) a thoraco-lumbar lesion. Mean age was 66.5 years (range 8-85) and the mean follow-up was 27.7 months (range 4-75). Mean preoperative and postoperative mMcCormick grade was 2.2 and 1.4 respectively, mean relative postoperative outcome was 28.6%. The average tumour volume was 55.4% of the spinal canal. The average remaining cord cross-sectional area was 67.7% of the estimated original value. The average tumour occupancy at maximum compression was 71.4%, the average cord occupancy at the same level was 20.8%. No correlation was seen between these values with preoperative and postoperative mMcCormick grade. On follow-up MRI the average cord area had increased to 91.6% without correlation with outcome.
Conclusion: Notwithstanding the important degree of cord compression we did not find a relationship between radiological measurements with neurological function before or after surgery, disclosing the complexity and the concurrence of still unknown factors in spinal cord functional recovery.
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