Spinal Meningioma: Symptoms, Causes and Treatment

For some people, persistent back pain or sudden numbness isn't just a minor issue—it may be the first sign of a spinal tumor.

Spinal meningioma, a slow-growing tumor in the protective layers around the spinal cord, can press on nerves, leading to pain, weakness, and mobility issues. Although rare, spinal meningiomas are among the most common spinal tumors, especially in middle-aged women.

While usually non-cancerous, they can still cause complications if untreated. Early detection and treatment are key to preserving nerve function and quality of life. This article covers the causes, symptoms, diagnosis, and treatment of spinal meningioma, providing essential information in a clear and accessible way.

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What is Spinal Meningioma?

Spinal meningioma is a slow-growing tumor that forms in the meninges, the protective layers around the spinal cord. While typically benign (non-cancerous), these tumors can cause significant symptoms by compressing the spinal cord or nerves.

They are most commonly found in the thoracic spine (mid-back) but can also occur in the cervical (neck) or lumbar (lower back) regions. The exact cause of spinal meningiomas is unknown, but factors like genetics, hormones, and aging may play a role.

Risk Factors

While the exact cause of spinal meningiomas is unknown, certain factors increase the likelihood of developing these tumors.

Gender: Women are three to four times more likely to develop spinal meningiomas than men, possibly due to hormonal influences. Some tumors contain hormone receptors, but the role of hormones in their growth remains unclear.
Genetics: Individuals with Neurofibromatosis Type 2 (NF2) have a higher risk of developing these tumors.
Age:The risk of spinal meningiomas increases with age, peaking between 70 and 84 years. These tumors are rare in younger individuals.

Symptoms of Spinal Meningioma

Symptoms develop gradually due to the tumor’s slow growth. Common signs include:

Back pain (often the earliest symptom)

Radiating pain to the arms or legs

Muscle weakness

Numbness or tingling

Balance and coordination problems

Bladder or bowel dysfunction

As the tumor grows, severe neurological deficits may occur, including:

Significant limb weakness or paralysis

Brown-Séquard syndrome (weakness on one side, numbness on the other)

Many patients delay seeking medical attention until symptoms interfere with daily life. Early diagnosis is key to preventing complications.

Diagnosis of Spinal Meningioma

Magnetic resonance imaging (MRI) is the primary tool for diagnosing spinal meningiomas. It provides detailed images that help determine the tumor's size, location, and effect on the spinal cord. Most spinal meningiomas appear as well-defined masses that enhance with contrast.

In some cases, additional imaging techniques, such as computed tomography (CT), may be used to detect calcifications. A biopsy is rarely needed since MRI findings are usually sufficient for diagnosis.

Treatment and Management

Surgery is the main treatment for spinal meningiomas.

The goal is complete tumor removal (gross total resection), which can often be achieved with microsurgical techniques.

Minimally invasive surgery (MIS) may be an option for smaller tumors, reducing recovery time and preserving spinal stability. In cases where complete removal is not possible, subtotal resection may be performed to relieve symptoms while minimizing surgical risks.
Radiation therapy may be used if the tumor cannot be entirely removed or if it recurs. Stereotactic body radiation therapy (SBRT) delivers targeted radiation to control tumor growth while minimizing damage to surrounding tissues.
Monitoring is an option for small, asymptomatic tumors. Regular MRI scans help track tumor growth and determine if intervention is needed.

Rehabilitation may be required after surgery, especially for patients with preoperative neurological deficits. Physical therapy can help restore strength and mobility.

For patients with aggressive or recurrent tumors, adjuvant therapy such as radiation may be considered, but chemotherapy is not typically used for spinal meningiomas.

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Key Takeaways

Spinal meningiomas are slow-growing tumors that develop in the protective layers around the spinal cord, most commonly affecting middle-aged women.

Symptoms progress gradually and may include back pain, radiating pain, muscle weakness, numbness, balance issues, and, in severe cases, paralysis.

MRI is the primary diagnostic tool, providing detailed imaging to assess the tumor’s size, location, and impact on the spinal cord.

Surgery is the standard treatment, aiming for complete tumor removal when possible; radiation therapy may be considered for incomplete removal or recurrence.