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Study Design <p>Retrospective comparative study.</p> Objectives <p>To compare surgical and clinical outcomes of thoracic intradural extramedullary (IDEM) meningiomas based on tumor location, specifically between ventral and dorsal/lateral lesions.</p> Methods <p>This study retrospectively analyzed 60 consecutive patients who underwent posterior surgical resection for thoracic IDEM meningiomas at a single institution between 2007 and 2022. Patients were stratified into two groups according to tumor location on preoperative MRI: Ventral group (n = 23) and Dorsal/Lateral group (n = 37). Clinical outcomes were assessed using the modified McCormick scale (MMCS). Surgical parameters and complications were also compared.</p> Results <p>Patients in the Ventral group had significantly larger sagittal tumor diameters and higher spinal canal occupancy rates than those in the Dorsal/Lateral group (p &lt; 0.05). Preoperative motor deficits were more frequent in the Ventral group (86.9 vs. 51.3%, p &lt; 0.01). Estimated blood loss was greater in the Ventral group (p = 0.01). Intraoperative motor evoked potential deterioration occurred more often (p = 0.04). Although both groups showed neurological improvement postoperatively, the percentage of patients reaching MMCS Grade I at final follow-up was significantly lower in the Ventral group (17.3 vs. 54.0%, p &lt; 0.01). No tumor recurrence was observed in either group during the follow-up period (mean: 61.4 months).</p> Conclusions <p>Ventrally located thoracic IDEM meningiomas are associated with more severe preoperative motor dysfunction and inferior postoperative neurological recovery compared to dorsal/lateral lesions. These findings highlight the importance of early surgical intervention and tailored surgical planning for ventral tumors to optimize functional outcomes.</p>

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Comparison of surgical and clinical outcomes between ventral and dorsal/lateral thoracic intradural extramedullary meningiomas: a retrospective study

  • 期刊论文

  • 发表日期：

    2025年10月27日

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  • Yu Suematsu,
  • Narihito Nagoshi,
  • Toshiki Okubo,
  • Masahiro Ozaki,
  • Satoshi Suzuki,
  • Kazuki Takeda,
  • Takahito Iga,
  • Morio Matsumoto,
  • Masaya Nakamura,
  • Kota Watanabe

摘要

Study Design

Retrospective comparative study.

Objectives

To compare surgical and clinical outcomes of thoracic intradural extramedullary (IDEM) meningiomas based on tumor location, specifically between ventral and dorsal/lateral lesions.

Methods

This study retrospectively analyzed 60 consecutive patients who underwent posterior surgical resection for thoracic IDEM meningiomas at a single institution between 2007 and 2022. Patients were stratified into two groups according to tumor location on preoperative MRI: Ventral group (n = 23) and Dorsal/Lateral group (n = 37). Clinical outcomes were assessed using the modified McCormick scale (MMCS). Surgical parameters and complications were also compared.

Results

Patients in the Ventral group had significantly larger sagittal tumor diameters and higher spinal canal occupancy rates than those in the Dorsal/Lateral group (p < 0.05). Preoperative motor deficits were more frequent in the Ventral group (86.9 vs. 51.3%, p < 0.01). Estimated blood loss was greater in the Ventral group (p = 0.01). Intraoperative motor evoked potential deterioration occurred more often (p = 0.04). Although both groups showed neurological improvement postoperatively, the percentage of patients reaching MMCS Grade I at final follow-up was significantly lower in the Ventral group (17.3 vs. 54.0%, p < 0.01). No tumor recurrence was observed in either group during the follow-up period (mean: 61.4 months).

Conclusions

Ventrally located thoracic IDEM meningiomas are associated with more severe preoperative motor dysfunction and inferior postoperative neurological recovery compared to dorsal/lateral lesions. These findings highlight the importance of early surgical intervention and tailored surgical planning for ventral tumors to optimize functional outcomes.