Spinal meningioma surgery in elderly patients with paraplegia or severe paraparesis: a multicenter study.
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.
Sacko
Oumar
O
Department of Neurosurgery, Purpan University Hospital, Toulouse, France. oumarsacko36@yahoo.fr
Haegelen
Claire
C
Mendes
Vivien
V
Brenner
Adam
A
Sesay
Musa
M
Brauge
David
D
Lagarrigue
Jacques
J
Loiseau
Hugues
H
Roux
Franck-Emmanuel
FE
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