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Thoracic Spine

Dorsal Spinal Meningiomas excision

Spinal meningiomas are the second most common spinal tumor. Although more common than other types of spinal tumors, recent advances have allowed for successful intervention and spinal meningioma treatment. Some of the first questions asked by most people that have been diagnosed are: what sort of treatment options are available? Is surgery necessary in every case? What are some alternatives to surgery?

What Is a Spinal Meningioma?

The spinal cord is located within the canal in the center of the spine. It is a complex network of nerves that delivers signals to the entire body. The bones (known as vertebrae) provide the first layer of protection against external factors that could damage the spinal cord. Beyond this, both the brain and spinal cord are encased in membranes known as the meninges; in the spine, the meninges acts as another layer of protection for the spinal cord and also for the brain within the skull.

When a tumor or lesion forms on or in the tissues of the meninges, it”s known as a meningioma. It”s important to note that in the vast majority of cases, these growths are benign, meaning they don”t contain any cancerous cells. Nonetheless, even if they”re not cancerous, depending on their size and location, they can still cause unpleasant and sometimes debilitating symptoms.

What Causes Spinal Meningiomas?

It”s not known exactly what causes meningiomas to develop, but there are certain risk factors such as genetic predispositions for meningeal growths, female hormones and previous radiation therapy. What is known is that they can occur anywhere throughout the meninges along the spinal column or around the brain. They can grow either on the outer or inner surfaces of the meninges or within the meninges itself.

Symptoms of Meningiomas

Some people may have a spinal meningioma for years and never notice any associated symptoms. When symptoms occur, they are related to spinal cord or spinal nerve compression. Typical symptoms are pain, numbness, weakness, and unsteadiness. These symptoms are often very slight at first, making diagnosis difficult initially.

What Options Are Available for Spinal Meningioma Treatment?

There are a number of spinal meningioma treatments used to relieve the symptoms or remove the tumor altogether. They can range from simply keeping an eye on the tumor through imaging (CAT Scan, MRI, etc.) to surgery to radiation therapy. If treatment is needed, the treatment of choice is usually surgery.

Monitoring

Monitoring may be the first recommended treatment for a spinal meningioma, depending on its location, size and rate of growth. This is often the case if the tumor or lesion is found to be very small and slow-growing or is not interfering with other structures such the spinal cord or spinal nerves.

Surgical Removal

If a meningioma causes neurological symptoms, compresses the spinal cord or grows significantly, treatment options will be explored and surgical removal will be considered as the first option. Microsurgical techniques have made spinal meningioma surgery fairly routine. Although there are still significant risks, the vast majority of surgery for spinal meningiomas goes smoothly. Many spinal meningiomas are amenable to minimally invasive surgery, which minimizes postoperative pain and leads to a faster recovery. If this is appealing to you, it is an option worth exploring.

Stereotactic Radiosurgery

Another potentially effective means of treatment for meningiomas is stereotactic radiosurgery, but this is not a great choice for spinal meningiomas. Radiosurgery involves a non-invasive, highly accurate, and lethal dose of radiation to a small area like a tumor. This makes it a great option for tumors in many areas that would be difficult to access via traditional or microsurgical methods. Even the most modern radiosurgery systems have difficulty shielding structures that are right next to the tumor being treated from getting a significant dose of radiation. Spinal meningiomas are usually so close to the spinal cord that radiation toxicity to the spinal cord remains a real concern.

Why Not Just Remove It?

Each spinal meningioma treatment needs to be tailored to a person”s specific case. For instance, if your meningioma is small and doesn”t compress the spinal cord, it would probably make sense to just monitor it. On the other hand, if a meningioma is large and is pressing against nerves and causing symptoms such as weakness on one side of your body, you should seriously consider surgery to maintain and even restore your ability to function. In cases of growing tumors that are not symptomatic, the patient”s age is a major consideration, as your surgeon should estimate what is the likelihood that your tumor will cause a problem in your lifetime.

If you have questions, don”t hesitate to ask them. Being informed is the first step in finding the right treatment for your spinal meningioma. It doesn”t matter what the circumstance is – the decision on how to proceed ultimately lies with you and your medical team and what will best address your particular case.