title: Spinal meningioma surgery in elderly patients with paraplegia or severe paraparesis: a multicenter study.
abstract: OBJECTIVE
  In a multicenter study, 102 patients aged 70 years or older with paraplegia or severe paraparesis, and who underwent operation for spinal meningiomas, are presented to correlate surgery and outcome and to determine the most influential factors that affected this outcome.
  
  
  METHODS
  Five French neurosurgical centers participated in this retrospective study between 1990 and 2007. Pre- and postoperative neurological status were assessed using a grading system. All patients underwent operation, and neurological evaluations were conducted 3 months and 1 year after surgery. The median follow-up period was 49.5 months (range, 12-169 months). Data were analyzed using a multiple logistic regression model.
  
  
  RESULTS
  Twenty-six patients were paraplegic (Grade 4). Complete tumor removal was obtained in 93 patients. There was no surgical mortality, and morbidity was 9%. Three months after surgery, 7 of the patients were unchanged, 87 patients had improved, and 8 were not evaluated. One year after surgery, 7 of the 100 surviving patients were clinically unchanged and 93 had improved. Of those who had improved, 49 patients experienced complete recovery.
  
  
  CONCLUSIONS
  Advanced age did not seem to contraindicate surgery, even in patients with severe preoperative neurological deficits and/or an American Society of Anesthesiologists class of III. Quality of life can be improved in most cases.
authors.affiliation: Department of Neurosurgery, Purpan University Hospital, Toulouse, France. oumarsacko36@yahoo.fr
authors.forename: Oumar
authors.initials: O
authors.lastname: Sacko
authors.forename: Claire
authors.initials: C
authors.lastname: Haegelen
authors.forename: Vivien
authors.initials: V
authors.lastname: Mendes
authors.forename: Adam
authors.initials: A
authors.lastname: Brenner
authors.forename: Musa
authors.initials: M
authors.lastname: Sesay
authors.forename: David
authors.initials: D
authors.lastname: Brauge
authors.forename: Jacques
authors.initials: J
authors.lastname: Lagarrigue
authors.forename: Hugues
authors.initials: H
authors.lastname: Loiseau
authors.forename: Franck-Emmanuel
authors.initials: FE
authors.lastname: Roux
mesh_terms: D017677:Age Distribution; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008577:Meningeal Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D008579:Meningioma / Q000453:epidemiology* / Q000601:surgery*; D020335:Paraparesis / Q000453:epidemiology* / Q000601:surgery*; D010264:Paraplegia / Q000453:epidemiology* / Q000601:surgery*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013125:Spinal Neoplasms / Q000453:epidemiology / Q000601:surgery; D016896:Treatment Outcome