Minimally Invasive Surgery for Cervical Meningioma: A Systematic Review and Case Series.

Abstract

Background: Meningiomas are benign spinal arachnoid tumours, typically presenting as intradural extramedullary (IDEM) lesions that can compress the spinal cord and require surgical intervention. Minimally invasive surgery (MIS) techniques like mini-open, tubular and endoscopic approaches minimize tissue manipulation, reduce pain and accelerate recovery. This systematic review provides insights into current practices regarding MIS for cervical meningioma and presents a case series of eight patients with cervical meningioma effectively managed by MIS.

Methods: A comprehensive literature search was conducted across Embase, PubMed and Medline Ovid, focusing on MESH terms related to cervical vertebrae, nervous system neoplasms and minimally invasive surgical procedures. Risk of bias in retained studies was assessed using the Joanna Briggs Institute Critical Appraisal tools for case series and case reports. A narrative synthesis of our results is presented.

Results: Nine studies with 15 patients undergoing MIS for cervical meningioma were included. Most tumours were at the craniospinal junction. Gross total resection (Simpson grade 2) was achieved in 14 cases, with no reported post-operative complications. The length of stay (LOS) ranged from 2 to 6 days, and no tumour recurrence was observed. Our case series of eight patients confirmed MIS benefits, including shorter operative times, comparable surgical outcomes, and the avoidance of spinal deformities requiring instrumentation.

Conclusion: In well-selected patients, MIS for cervical meningioma is a safe and effective procedure offering direct lateral access, minimal bony resection, limited soft tissue manipulation, and avoidance of cervical fusion, thereby minimizing post-operative complications and LOS.