Spinal meningioma: Chronicles of contemporary neurosurgical diagnosis and management

Spinal meningiomas are uncommon entities that fortunately burden only a small minority of patients. Notwithstanding their overwhelmingly benign propensity, the occurrence of extramedullary meningioma may nonetheless cause significant morbidity and possible mortality. The consideration therefore, of spinal meningioma in the differential of patients presenting with radiculopathy or complaints of chronic back or neck pain should not be disregarded. The rapidity of diagnosis and the first neurosurgical encounter are cornerstones in patient longevity and neurological preservation. The advent of microsurgical techniques and magnetic resonance imaging and surgical techniques has notably improved clinical outcomes over the past two decades. However, surgical candidacy may be limited. particularly in those patients with significant preexisting medical comorbidities, aggressive or recurring tumors, or multiple lesions. Alternative management strategies such as stereotactic radiosurgery or less invasive surgical techniques are currently underway in clinical practice. A review on neurosurgical diagnosis and treatment modalities in the management of spinal meningioma is therefore pertinent. (C) 2008 Elsevier B.V. All rights reserved