Because spinal meningiomas are infrequently encountered in any one center, a large portion of the literature relating to spinal meningiomas consists of case reports or case series 1)
In The Surveillance, Epidemiology and End Results, the age-adjusted incidence rate was 0.37 cases per 1,000,000 person-years between 2004 and 2016. Spinal meningiomas represented 4.25% of all meningiomas. A total of 4204 patients with spinal meningiomas were included in the study. Most of the patients were white and diagnosed at 60-69 years of age, and the female:male ratio was 4:1. Most of the tumors were benign and less than 3 cm in size. The most common pathological type was psammomatous meningioma. Surgery was the first choice of treatment for patients with spinal meningiomas. Male and pediatric patients were more vulnerable to borderline or malignant spinal meningiomas. Survival analysis showed that married, female, and younger patients with benign meningiomas had better overall survival than their counterparts 2).
Approximately 1000 spinal meningiomas were diagnosed in the United States per year, and the incidence was relatively stable. Advanced age, female sex, Asian Pacific Islander and Caucasian race, and Hispanic ethnicity were all associated with an increased incidence of spinal meningioma. The study of represents the most comprehensive evaluation of population-based descriptive epidemiology of spinal meningiomas in the United States to date 3).
Spinal meningiomas represent a significant fraction of all primary intradural spinal tumors and of all meningiomas. The results of a study of Westwick and Shamji established the association of lesion incidence and survival with sex, with a less frequent incidence in but greater mortality among males 4).
Meningiomas arising from the coverings of the spinal cord are one of the two most common intradural extramedullary spinal tumors, representing 25-30% of all such tumors 5)
They have a peak incidence in the fifth and sixth decades. Interestingly, and unlike intracranial meningiomas, in the adult population, females are approximately ten times more commonly affected than males. In children, there does not appear to be a sex predilection.
There is an increased incidence of spinal meningiomas in patients with neurofibromatosis type 2 (NF2), and in fact in the paediatric population, meningiomas uncommonly occur outside of the setting of NF2.
Except in cases of neurofibromatosis, it is very rare for tumors of different pathological types to exist concurrently at the same spinal level, with only 9 cases reported to date, in which spinal meningioma was found with spinal schwannoma in 7 cases and with spinal neurofibroma in 2 cases 6).
Amongst the intraspinal location, meningiomas account for 25% to 46% of primary spinal neoplasms, while the incidence of spinal meningiomas is 7.5% to 12.7% of all meningiomas
Thoracic Spine: The majority of spinal meningiomas (about 80%) occur in the thoracic spine. This region has the most significant number of tumors due to the anatomical and physiological characteristics of the meninges and spinal cord in this area. Cervical and Lumbar Spine: Approximately 15% of spinal meningiomas are found in the cervical spine and about 5% in the lumbar spine. Extradural and Intradural: Most spinal meningiomas are intradural-extramedullary, meaning they are located within the dural sac but outside the spinal cord. A small percentage can be purely extradural, arising outside the dural sac.