Results in the Operative Treatment of Elderly Patients with Spinal Meningiomas

ABSTRACT

Objective: With the life expectancy in the industrial nations increasing over the last two decades; the number of patients older than 70 years with spinal tumors and; especially; meningiomas is rising. Our objective is 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. Patients and methods: Twenty seven consecutive patients over 70 years of age (mean age; 78.3 years) were operated on for spinal meningiomas between 1995 and 2005 in Bordeaux's Neurosurgery Departement. 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. Tumor were removed totally in 26 cases and subtotally removed in one. The follow-up period ranged from 12 to 81 months (mean; 27.1 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 0.01). Clinical outcome was not influenced by the preoperative general health conditions according to American Society of Anesthesiology classification (p0.07). Clinical outcome was influenced by the duration of symptoms before surgery (p0.05). No recurrence was observed during the follow-up period. Conclusion: 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 for those with a poor preoperative neurologic condition. Whenever there is an acceptable risk from an anesthesiological point of view