title: Ossified spinal meningiomas: Clinical and surgical features.
abstract: OBJECTIVE
  Meningiomas constitute 25% of primary spinal tumors and predominantly involve the thoracic spinal cord. Although calcifications are commonly seen in intracranial meningiomas, gross calcifications are observed in only 1-5% of all spinal meningiomas. We report the clinical findings, surgical strategy and histological features of 9 patients with ossified spinal meningiomas (OSMs).
  
  
  METHODS
  Clinical and surgical features of 9 patients with ossified spinal meningiomas were retrospectively reviewed.
  
  
  RESULTS
  There were 8 women and 1 man with a mean age of 59 years. In 7 patients, the lesions were localized in the thoracic segment of the spine while in 2 patients in the lower cervical segment. All patients presented with weakness of the lower limbs and hypoesthesia below the site level of the lesion. Only 2 patients presented with urinary incontinence. Gross-total resection of the tumor was achieved in 6 patients while in 3 a subtotal removal of the meningioma was obtained. In all patients the postoperative course was uneventful. Six patients presented with a significant neurological improvement while in 3 patients a mild improvement was observed. Microscopically, all tumors showed typical histological pattern of ossified meningioma.
  
  
  CONCLUSIONS
  OSMs are amenable to surgery if the complete removal can be achieved. Because of their hard-rock consistency complete resection can be challenging. In difficult cases, subtotal removal can be advised and follow-up imaging is mandatory. Overall, the risk of long-term recurrence of the lesions is low, and a good clinical outcome after total or subtotal removal can be expected.
authors.affiliation: Department of Neurosurgery, University of Messina, Italy. Electronic address: calafaci@unime.it.
authors.forename: Concetta
authors.initials: C
authors.lastname: Alafaci
authors.affiliation: Neurosurgical Clinic, Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, School of Medicine, Palermo, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grasso
authors.affiliation: Department of Neuroradiology, University of Messina, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Granata
authors.affiliation: Department of Neurosurgery, University of Messina, Italy.
authors.forename: Francesco M
authors.initials: FM
authors.lastname: Salpietro
authors.affiliation: Department of Neurosurgery, University of Messina, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tomasello
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Gross total resection; Metaplastic meningioma; Ossified spinal tumor