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-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 (n = 90 patients), cord and tumor occupancy as well as cord compression and tumor volume showed a correlation with preoperative mMCS (p < 0.05, R -0.23; p < 0.001, R 0.35; p < 0.005, R -0.29; p < 0.001, R 0.42). Cord occupancy had a strong correlation with cord compression (p < 0.001, R 0.72). Tumor occupancy and TCR were correlated with relative outcome at follow-up (p < 0.005 R 0.3; p < 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 (p < 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.
['Baro|Valentina|V|0000-0002-5642-4289', 'Moiraghi|Alessandro|A|0000-0003-4569-5304', 'Carlucci|Valentina|V|', 'Paun|Luca|L|', 'Anglani|Mariagiulia|M|', 'Ermani|Mario|M|', 'Saladino|Andrea|A|', 'Chioffi|Franco|F|', "d'Avella|Domenico|D|", 'Landi|Andrea|A|0000-0002-7185-7779', 'Bartoli|Andrea|A|', 'DiMeco|Francesco|F|', 'Schaller|Karl|K|', 'Denaro|Luca|L|0000-0002-2529-6149', 'Tessitore|Enrico|E|0000-0002-7116-6302']
spinal meningioma cord compression McCormick scale tumor volume functional outcome magnetic resonance imaging