Results in the Operative Treatment of Elderly Patients with Spinal Meningiomas

STUDY DESIGN: Thirty consecutive patients over 70 years of age who were operated on for spinal meningiomas are presented to assess surgical criteria and postoperative outcome. OBJECTIVES: To assess the outcome of surgically treated spinal meningiomas in patients in their eighth or ninth decade of life and to analyze the possible role of some prognostic factors. SUMMARY OF BACKGROUND DATA: The ageing of the population in the industrial nations has led to increased findings of benign spinal tumors, namely meningiomas, in the elderly. These slow-growing tumors may prevent these patients from leading an autonomous life. Little is known about the outcome of spinal meningioma surgery in patients of 70 years or older because the number of these patients, although increasing, is still small. METHODS: Thirty consecutive patients over 70 years of age (mean age, 77.1 years) were operated on for spinal meningiomas between 1986 and 2001. The preoperative neurologic status of the patients was graded with the Solero score, and the general health conditions were staged according to the American Society of Anesthesiology classification. Total tumor removal was achieved in 27 patients. The follow-up period ranged from 17 to 173 months (mean, 62.7 months). RESULTS: There was no operative mortality, and morbidity was not significant. Although not significant, neurologic outcome was better in patients with a low preoperative Solero score than those with a high one (P = 0.06). Clinical outcome was not influenced by the duration of symptoms before surgery or preoperative American Society of Anesthesiology classification. No recurrence was observed during the follow-up period. CONCLUSIONS: Neurologic outcome following surgery was favorable in the vast majority of patients, with no mortality or significant morbidity. Surgery is the only treatment in elderly patients with symptomatic spinal meningiomas, even those with a poor preoperative neurologic condition, whenever there is an acceptable risk from an anesthesiological point of view.