Age-specific clinical results in spinal meningioma surgery: should age still be considered detrimental to satisfactory outcomes?

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY
Alessandro Pesce, Mauro Palmieri, Mattia Capobianco, Antonio Santoro, Maurizio Salvati, Alessandro Frati
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Abstract

Objective: Spinal meningiomas (SMs) are relatively rare primary spinal neoplasms, and the increasingly growing mean age and number of older patients presenting with spinal neoplasms raise questions concerning the costs and benefits of proposing surgical intervention. The aim of this study was to analyze the outcomes and complications of a large cohort of older patients with SMs to define the real benefit of surgery in these patients.

Methods: A total of 261 SMs were operated on between 1976 and December 2021, and 156 matched the inclusion criteria for the final cohort. Patients were divided into three groups according to age: < 50 years (group A), between 51 and 74 years (group B), and > 75 years (group C). Neurological and clinical outcomes, resection grade, complications, histology, and possible recurrences were evaluated.

Results: The final cohort comprised 156 patients (126 females, 30 males) with a mean ± SD age of 55.93 ± 14.80 years. The mean follow-up was 41.5 ± 11.4 months. Group A was found to have a significantly higher Frankel score at follow-up; there was no significant difference between mean scores for groups B and C. Nevertheless, there was no significant difference between the subgroups in patients who showed improvement from their preoperative neurological condition. Only 3 recurrences were recorded, all in group A. Axial topography, level of the lesions, and preoperative symptoms, including impairment of the sphincter functions, demonstrated no statistically significant interaction in the subgroups.

Conclusions: The present study supports the concept that older age might not be a contraindication for surgical treatment in SMs because of the important improvements in functional status and quality of life achieved in this population subgroup. Older patients can benefit from prompt assessment and early surgery in cases of acute onset, with a complication rate not higher than that of younger patients.

脊髓脑膜瘤手术的特定年龄临床结果:是否仍应将年龄视为影响满意结果的不利因素?
目的:脊髓脑膜瘤(SMs)是一种相对罕见的原发性脊髓肿瘤,随着平均年龄的增长和脊髓肿瘤老年患者人数的增加,提出了有关手术干预的成本和收益的问题。本研究旨在分析一大批老年脊柱肿瘤患者的预后和并发症,以确定手术治疗对这些患者的真正益处:1976年至2021年12月期间,共有261名SM患者接受了手术,其中156人符合最终队列的纳入标准。患者按年龄分为三组:< 小于50岁(A组)、51至74岁(B组)和大于75岁(C组)。对患者的神经和临床疗效、切除等级、并发症、组织学和可能的复发进行了评估:最终共有 156 名患者(女性 126 人,男性 30 人),平均年龄为(55.93±14.80)岁。平均随访时间为(41.5 ± 11.4)个月。随访时发现,A 组的 Frankel 评分明显更高;B 组和 C 组的平均评分没有明显差异。轴向地形图、病变水平和术前症状(包括括约肌功能受损)在亚组中没有统计学意义上的交互作用:本研究支持这样一种观点,即年龄较大可能不是 SM 手术治疗的禁忌症,因为该亚组患者的功能状态和生活质量得到了显著改善。在急性发病的情况下,老年患者可以从及时评估和早期手术中获益,其并发症发生率并不比年轻患者高。
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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
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