Abstract

Spinal meningioma are rare tumor, about 5% of central nervous system tumors, and generally benign. Their origin is most often a solitary proliferation of arachnoid cells. The descriptive and analytical purpose of our study is to draw up the epidemiological, clinical, para clinical, therapeutic and evolutionary profiles of spinal meningioma in our formation and to compare our results with data from the literature. This will allow us to focus on the difficulties encountered during the diagnosis and management of this disease. This is a retrospective study of 36 cases of spinal meningioma operated in the neurosurgery department of CHU Mohamed VI, between January 2002 and December 2020. Spinal meningioma represented 17% of slow spinal cord compression operated during the same period. With an annual incidence of 1.8 cases/year, the female predominance was very clear with a percentage of 77.78% against 22.23% for men. The average age of our patients was 50 years old with extremes ranging from 28 to 72 years old. Clinically, the consultation time was on average 6 months with extremes ranging between 1.5 months and 02 years. The clinical examination was able to objectify a spinal cord compression syndrome in 31 patients (86.11%), a lesion syndrome in 13 patients (36.11%) and a sub-lesion syndrome in 20 patients (90.9%). Spinal magnetic resonance imaging is the most effective examination for locating the tumor and recommending treatment. It was performed in all our patients. The most frequent locations are at the thoracic level (55%), then lumbar (28%) and cervical (17%). In our study, almost all patients underwent complete resection, except 04 patients where the resection was partial. All were done posteriorly. Spinal meningioma is characterized by the poverty and non-specificity of clinical signs, this aspect seems to be illustrated in our series, by the average admission time of 6 months and a diagnostic delay exceeding 6 months in 42.85% of cases. Spinal meningioma evolves gradually, resulting in clinical signs of slow cord compression. Spinal meningiomas are usually benign tumors that develop from arachnoid cells. Their diagnosis is mainly based on magnetic resonance imaging. Their care should not suffer any delay and this from the onset of the first symptoms.

Keywords: Spinal Meningioma; Spinal Cord Compression Syndrome; Magnetic Resonance Imaging; Surgical Excision

References

1. Solero C and Fornari M. “Spinal meningioma: review 147 operated cases”. Neurosurgery Clinics of North America 5 (1994): 238-291.
2. Morandi X., et al. “Spinal and intraspinal tumors”. Encycl Med surgery (2001): 17-275-a-10.
3. Mahfoud H. “Management of spinal cord compression in CHU Med VI”. Thesis Doctorate in Medicine, Marrakech 51 (2007): 143.
4. V Ravinda and M Shmidt. “Management of Spinal Meningiomas”. Neurosurgery Clinics of North America 2 (2016): 195-205.
5. Mireau E., et al. “Slow spinal cord compression”. Encycl Méd Chir Neurologie (2009): 17-665-A-10,12p.
6. Kabre A., et al. “Intra-spinal meningiomas about 14 cases”. Dakar Médical 37 (1992): 2.
7. Salama J and Redona A. “Spinal cord compression of tumor origin”. Encycl Méd Chir Neurol 85 (2003): 155-176.
8. Braun M., et al. Medullary Imaging”. Encycl Méd Chir Neurologie (2003): 17-035-A-60,31p.
9. Deyerdelhan O., et al. “MRI aspects of spinal neuromas and meningiomas”. Journal of Neuroradiology1 (2005): 42-49.
10. Klekamp J and Sami M. “Surgical results for spinal meningiomas”. Surgical Neurology 6 (1999): 552-562.
11. W Levy., et al. “Spinal cord meningioma”. Journal of Neurosurgery 6 (1982): 804-812.
12. C Solero., et al. “Spinalmeningio-mas: review of 174 operated cases”. Neurosurgery2 (1989): 153-160.
13. LM P Terrier and P François. “Multiple meningiomas”. Neurosurgery 3 (2016): 128-135.
14. Desgeorges M., et al. “Laser microsurgery of meningiomas, Analysis of a consecutive series of 164 cases operated with different lasers”. Neurosurgery4 (1992): 217-225.
15. J Klekamp and M Saml. “Surgical results for spinal meningiomas”. Surgical Neurology 6 (1999): 552-562.
16. A Kabre., et al. “Intra-spinal meningiomas about 14 cases”. Dakar Medical 37 (1992): 2.
17. M Harrison., et al. “Radiation induced méningiomas: experience at the mount Sinai hospital land review of the literature”. Journal of Neurosurgery 4 (1991): 564-574.
18. Lunsford L. “Contemporary management of meningioma: radiation therapy as an adjuvant and radiosurgery as an alternative to surgical removal”. Journal of Neurosurgery 2 (1994): 187-190.
19. Calmels P., et al. “Rehabilitation of spinal cord injuries”. Medical Competition 122 (2000): 678-682.
20. Alaywane M and Sindou M. “Prognostic factors in intracranial meningioma surgery. Role of tumor size and arterial vascularization of pie-meridian origin. Study of 150 cases”. Neurosurgery6 (1993): 337-347.
21. Figarella-Branger D., et al. “Prognostic factors in meningiomas”. Annales de Pathologie 5 (2000): 438-447.