1. Long-term recurrence rates after the removal of spinal meningiomas in relation to Simpson grades
- Author
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Joo-Kyung Sung, Chun Kee Chung, Sang Hoon Yoon, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim, Whan Eoh, Yunhee Choi, Kyoung-Tae Kim, Seung-Jae Hyun, Chi Heon Kim, Eun-Sang Kim, and Sun-Ho Lee
- Subjects
Male ,medicine.medical_specialty ,Meningioma ,03 medical and health sciences ,0302 clinical medicine ,Meningeal Neoplasms ,medicine ,Back pain ,Humans ,Orthopedics and Sports Medicine ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Spinal Meningiomas ,Magnetic resonance imaging ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,030220 oncology & carcinogenesis ,Radiological weapon ,Total removal ,Female ,Neurosurgery ,Neoplasm Recurrence, Local ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Simpson grade II removal (coagulation of the dural attachment after gross total removal) of spinal meningioma is considered an acceptable alternative, but increased recurrence after more than 10 years has been reported. More attention must be paid to the long-term surgical outcomes after Simpson grade II removal. A retrospective review was performed for 20 patients (M:F = 5:15; age, 59 ± 9 years) with Simpson grade II removal (mean follow-up period, 12.9 years; range 10.0–17.5). Magnetic resonance (MR) imaging was conducted in 17 patients at 88 ± 52 months (range 12–157). During the same period, Simpson grade I removal (removal of the dural origin) was performed in 21 patients (follow-up, 89 ± 87 months; range 9–316). Radiological recurrence was defined as a visible tumor on a follow-up MR image, and clinical tumor recurrence was defined as the recurrence of symptoms. At the final follow-up, neurological symptoms had improved in 16/20 patients and remained stable in 4/20. A recurrent tumor was detected in one patient due to increased back pain at 92 months postoperative, but the symptom was stable without surgery until the last follow-up (124 months). The radiological and clinical recurrence-free survival periods were 150 ± 7 months (95 % CI 136–163) and 204 ± 6 months (95 % CI 193–215), respectively. There was no recurrence after Simpson grade I removal, whereas neurological deterioration occurred in two patients after surgery. Simpson grade II removal may be an alternative option if the risk of complications with Simpson grade I removal is expected to be high.
- Published
- 2015