Background: The main treatment modality for spinal meningiomas (SM) is gross total resection (GTR). However, the optimal timing of surgery, especially in cases with absent or mild neurological symptoms, remains unclear. The aim of this study is to assess the impact of early-stage resection on neurological outcome, quality of life (QoL), and quality of care. The primary objective is a favorable neurological outcome (McCormick scale 1). Methods: We retrospectively analyzed data from patients who underwent operations for SM between 2011 and 2021. Patients with mild neurological symptoms preoperatively (McCormick scale 1 and 2) were compared to those with more severe neurological symptoms (McCormick scale 3–5). Disabilities and QoL were assessed according to validated questionnaires (SF-36, ODI, NDI). Results: Age, spinal cord edema, thoracic localization, and spinal canal occupancy ratio were associated with more severe neurological symptoms (allp< 0.05). Patients presenting with mild symptoms were associated with favorable neurological outcomes (OR: 14.778 (95%CI 3.918–55.746,p< 0.001)), which is associated with shorter hospitalization, better QoL, and fewer disabilities (p< 0.05). Quality of care was comparable in both cohorts. Conclusions: Early surgical intervention for SM, before the development of severe neurological deficits, should be considered as it is associated with a favorable neurological outcome and quality of life.
背景：脊髓脊膜瘤的主要治疗方式是肿瘤全切除术。然而，手术的最佳时机，尤其是在无或仅有轻微神经症状的病例中，仍不明确。本研究旨在评估早期切除对神经功能预后、生活质量和护理质量的影响，主要观察指标为良好的神经功能预后（McCormick量表1级）。方法：我们回顾性分析了2011年至2021年间接受脊髓脊膜瘤手术的患者数据。将术前神经症状轻微（McCormick量表1-2级）的患者与神经症状较重（McCormick量表3-5级）的患者进行比较。功能障碍与生活质量通过标准化问卷（SF-36、ODI、NDI）进行评估。结果：年龄、脊髓水肿、胸段定位及椎管占位比与更严重的神经症状相关（均p<0.05）。症状轻微的患者与良好的神经功能预后显著相关（OR: 14.778，95%CI 3.918–55.746，p<0.001），且与更短的住院时间、更好的生活质量及更轻的功能障碍相关（p<0.05）。两组的护理质量无显著差异。结论：对于脊髓脊膜瘤，在出现严重神经功能缺损前进行早期手术干预值得考虑，因其与良好的神经功能预后及生活质量改善相关。
Timing of Resection of Spinal Meningiomas and Its Influence on Quality of Life and Treatment
肿瘤(癌症)患者之家