Spinal meningioma classification [Neurosurgery Wiki]

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====== Spinal meningioma classification ======

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see also [[Meningioma classification]].
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===== Anatomical Classification (Location-Based) =====

Dorsal (Posterior) meningiomas: Most common, arise from the dura mater at the posterior aspect of the spinal cord.

Lateral meningiomas: Originate from the dura along the lateral aspect of the spinal cord.

Ventral (Anterior) meningiomas: Arise from the anterior dura, often more challenging to access surgically.

Foraminal meningiomas: Extend into the intervertebral foramina.
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Extramedullary-intradural meningiomas: The majority of spinal meningiomas fall into this category.

Extramedullary-extradural meningiomas: Rare, extending beyond the dura mater.

Dumbbell-shaped meningiomas: Exhibit both intradural and extradural components.

In the series of Haddad et al. the sites of dural attachments were as follows: 16 (11.3%) dorsal, 31 (22.0%) dorsolateral, 17 (12.1%) lateral, 40 (28.4%) ventral, and 37 (26.2%) ventrolateral
((Haddad AF, Safaee MM, Pereira MP, Oh JY, Lau D, Tan LA, Clark AJ, Chou D, Mummaneni PV, Ames CP. Posterior-based resection of spinal meningiomas: an institutional experience of 141 patients with an average of 28 months of follow-up. J Neurosurg Spine. 2022 Sep 23:1-8. doi: 10.3171/2022.7.SPINE211603. Epub ahead of print. PMID: 36152326.))

===== Bayoumi classification =====

{{::spinal_meningioma_classification.jpg?500|}}

Bayoumi et al. reviewed the literature to report on previously published [[cohort]]s and [[classification]]s used to describe the [[location]] of the tumor inside the [[spinal canal]]. They reviewed the cases that were published prior showing non-conventional surgical approaches to resect [[spinal meningioma]]s. They proposed a classification system composed of Staging based on maximal cross-sectional surface area of tumor inside canal, Typing based on number of quadrants occupied by tumor and Subtyping based on location of the tumor bulk to spinal cord. Extradural and extra-spinal growth were also covered by our classification. They then applied it retrospectively on our 58 cases.

12 articles were published illustrating overlapping terms to describe spinal meningiomas. Another 7 articles were published reporting on 23 cases of anteriorly located spinal meningiomas treated with approaches other than laminectomies/laminoplasties. 4 Types, 9 Subtypes and 4 Stages were described in our Classification System. In our series of 58 patients, no midline anterior type was represented. Therefore, all our cases were treated by laminectomies or laminoplasties (with/without facetectomies) except a case with a paraspinal component where a costotransversectomy was needed.

Spinal meningiomas can be radiologically described in a precise fashion. Selection of surgical corridor depends mainly on location of tumor bulk inside canal
((Bayoumi AB, Laviv Y, Yokus B, Efe IE, Toktas ZO, Kilic T, Demir MK, Konya D, Kasper EM. Proposal of a new radiological classification system for spinal meningiomas as a descriptive tool and surgical guide. Clin Neurol Neurosurg. 2017 Nov;162:118-126. doi: 10.1016/j.clineuro.2017.10.001. Epub 2017 Oct 3. PMID: 29031234.)).

===== Spinal extradural meningioma =====


see [[Spinal extradural meningioma]].

===== Cervical spinal meningioma =====

see [[Cervical spinal meningioma]].

===== Thoracic spinal meningioma =====

[[Thoracic Spinal Meningioma]]

===== Lumbar spinal meningioma =====
[[Lumbar spinal meningioma]]