Table of Contents
Spinal meningioma classification
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.
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 1)
Bayoumi classification
Bayoumi et al. reviewed the literature to report on previously published cohorts and classifications 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 meningiomas. 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 2).