SPINAL MENINGIOMA

A meningioma is a tumor that grows in one of the meninges, the coverings that protect the spinal cord. The majority of these tumors are non-malignant.  

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3 percent of individuals with progressive curvature may eventually experience severe problems that can include scoliosis and back pain, spinal problems, and nerve compression causing numbness, weakness, and leg pain.

Meningioma

A meningioma is a tumor that grows in one of the meninges, the coverings that protect the brain and spinal cord. The dura mater, arachnoid membrane, and pia mater, which are located just below the skin and skull, make up the meninges. A meningioma can manifest practically anywhere since the meninges span the whole brain and spinal column. About 25% of all tumors that affect the spinal canal are meningiomas. Although these tumors can happen anywhere along the spine, the thoracic (mid-spine) area is where they most frequently occur, perhaps because it is the greatest part of the spine.

What Is a Meningioma?

As previously mentioned, a meningioma is a tumor that grows in your meninges, which are 3 layers of tissue that cover and defend your brain and spinal cord. Particularly, the thin, spiderweb-like membrane that protects your brain and spinal cord contain cells called arachnoid cells, which are the source of meningiomas. Although sometimes cancerous, most meningiomas are benign. A tumor’s ability to invade other tissues and its potential for metastasis to other regions of your body are all indications that it is malignant.

Spinal Meningioma Symptoms

The pressure that the expanding tumor puts on the spinal cord or spinal nerves is what causes the symptoms of a spinal meningioma. Symptoms of a spinal meningioma include:

  • Walking and balancing are difficult
  • Back pain
  • Neck pain
  • Leg Pain
  • General weaknesses
  • Gait Disturbances
  • Arms or legs with muscle spasms
  • Paresthesia
  • Damage to bladder or bowel control

Spinal meningioma is very common in women. The exact cause of meningioma is not known, but progesterone and estrogen have been linked to tumor growth. Studies show that in meningeal tumors, the NF2 gene, which produces the Merlin protein, which normally inhibits cell growth reveals there is an anomaly. Scientists have also found abnormalities in a protein called survivin, which normally enables programmed cell death. Radiation therapy is associated with an increased incidence of spinal meningioma in individuals approximately 20 years after exposure.

What Causes Meningiomas?

Meningiomas are unknown to have a specific etiology. These tumors could develop more quickly due to hormonal changes. To validate this, though, additional study is required. In a considerable portion of meningiomas, scientists have discovered a chromosomal defect. As a result, it is possible that the cancers are brought on by hereditary factors. This particular chromosome inhibits the development of tumors.

Types

While some meningioma varieties develop slowly and do not spread, others grow more rapidly and are more hazardous. There are three different meningioma kinds or grades. A doctor evaluates the grade in light of elements like:

  • The location of the tumor.
  • A classification of the tumor.
  • The size of the spread.
  • Genetic results.
  • Age of the subject.
  • The quantity of tumor that is still present after surgery.

Doctors grade meningiomas from 1 to 3. Grade 1 is the most common type and grows slowly. People with grade 2 meningiomas are more likely to have their tumors come back after surgery to remove the original tumor. Grade 3 meningiomas are the rarest but most serious type. Meningiomas that are Grade 2 and 3 often metastasize or recur, even after surgery. Grade 2 meningiomas can spread from the meninges to the surrounding spine and bone tissue. Grade 3 meningioma can spread to the brain and other organs.

On microscopic inspection, grade 2 meningioma cells show an unusual look — when compared to normal meningeal cells.  Furthermore, those with grade 3 meningiomas show an extremely abnormal look. This is what doctors refer to as an anaplastic look. Meningiomas of higher grades are more prevalent in men than in women, according to the National Cancer Institute. The majority of meningiomas occur in black persons and adults 60 years and older.

Are Spinal Meningiomas Curable?

Our doctors completely remove most meningiomas. If your doctor catches it early and it’s not causing symptoms, you may not need to treat it right away. If the surgeon completely removes a tumor that is graded as a 1, there is a high chance that it will not recur. However, high-graded tumors may recur. Higher-graded meningiomas are more difficult to cure, and if those tumors are malignant, they result in shorter overall survival rates. Following surgery, radiation treatment may increase survival rates and lower the likelihood of regrowth and spreading.

How are Meningiomas Diagnosed?

Meningiomas frequently become known as a result of symptoms a person experiences. The following examinations will identify meningiomas:

Neurological exam

Your doctor may question you about your symptoms and may do a neurological examination to check for any changes in your mood, behavior, vision, coordination, balance, or motor and sensory function.

Imaging

Using an MRI or CT scan to create an image of the spinal cord will help the doctor to identify a meningioma.

Biopsy

In addition, your doctor could decide to take a sample of the tumor so they can look at it under a microscope before determining the diagnosis.

Living with a Meningioma

Meningiomas frequently grow slowly and without any signs in their victims. Experts could advise attentive waiting because of this. This implies that you will inform your healthcare practitioner of any new symptoms. Additionally, in order to monitor even tiny changes in the tumor, he or she will routinely request scans. Doctors use this option for treating small, asymptomatic tumors, especially for older people who cannot undergo surgery or radiation therapy because of other medical conditions.

Treatment

Each spinal meningioma treatment must be customized to the unique circumstances of each patient. For instance, it would probably make sense to only watch a meningioma if it is modest and does not compress the spinal cord. On the other hand, you should definitely consider surgery to preserve and maybe even restore your capacity to function if a meningioma is big, pushing on nerves, and producing signs like paralysis on one side of your body. Thankfully, a number of spinal meningioma treatments can successfully remove the tumor. Also, these treatment choices might range from straightforward monitoring to spine surgery.  And if certain circumstances are present, doctors will recommend radiation to shrink and eliminate the tumor.

Monitoring/Observation

A spinal meningioma may just require simple monitoring, depending on its size, location, and pace of growth. In a patient who fits the following description, doctors will observe the patient.

  1. Patients without symptoms or those whose symptoms are not bothersome to the patient
  2. Patients who are at high risk due to additional comorbid conditions that are more urgently life-threatening

Surgery

By squeezing the spinal cord or the nearby nerve roots, a meningioma in the spine might result in neurological pain symptoms. The only effective treatment for this structural issue is surgical excision of the spine tumor. The majority of the time, our surgeons can surgically remove an entire meningioma. Even though the operation aims to completely remove the tumor, it is only during surgery that the tumor and any linkages to other tissues occur.

The spinal tumor may have encroached on nearby bones, tissues, or blood vessels while growing around nerves, blood vessels, or the spinal cord. However, if the doctors decide that removing a tumor entirely entails a high risk of morbidity, they might decide to leave some of the tumor attached to vital anatomical structures and then either monitor with imaging tests or advise radiation therapy to stop a recurrence of either a benign or malignant tumor.

Radiation Therapy

Radiation therapy is rarely used to treat spinal meningiomas and uses high-energy rays to destroy cancer cells and abnormal cell growth. Ideally, radiotherapy is considered a viable option when tumor location makes surgery too risky to completely resect the tumor. Also, radiation therapy involves a highly precise, non-invasive dose of radiation directed at the tumor. Modern delivery methods significantly reduce the risk of long-term radiation damage and limit exposure to surrounding anatomy. Commonly used radiotherapy techniques include intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT). These techniques use a specific type of radiation whose protons are focused only on the tumor. The main advantage of these methods is that they are less damaging to the tissue surrounding the tumor.

Chemotherapy

Because of its side effects and associated risks, chemotherapy is rarely utilized for treating spinal meningioma.

Stereotactic Radiosurgery

Stereotactic radiosurgery is a viable alternative treatment option for meningiomas, although it is not a good option for spinal meningiomas. In radiosurgery, a tiny region, such as a tumor, receives a deadly dosage of radiation in a non-invasive, extremely precise manner. This makes it an excellent choice for malignancies in several locations that would be challenging to approach with conventional or microsurgical techniques. Even the most advanced radiosurgery techniques have trouble protecting nearby structures from receiving a considerable dose of radiation. Radiation poisoning of the spinal cord is a legitimate issue since spinal meningiomas are typically so near to the spinal cord.

 

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