Current Knowledge on Spinal Meningiomas Epidemiology, Tumor Characteristics and Non-Surgical Treatment Options: A Systematic Review and Pooled Analysis (Part 1)

SIMPLE SUMMARY: Spinal meningiomas are the most common adult primary intradural spinal tumors and an up-to-date comprehensive summary of the current knowledge is greatly needed. An extensive review of the literature covering all aspects of spinal meningiomas was performed and a total of 104 studies were included. The pooled analysis revealed that most patients were female, in their seventh decade of life, with WHO grade 1 tumors. Moreover, interregional and age-related differences in epidemiology and/or histology were found. Sensory and motor dysfunction as well as pain were the most common presenting symptoms. Despite some promising results, the benefits of non-surgical treatments remain controversial. ABSTRACT: Background: Spinal meningiomas are the most common primary intradural spinal tumors. Although they are a separate entity, a large portion of the knowledge on spinal meningiomas is based on findings in intracranial meningiomas. Therefore, a comprehensive review of all the literature on spinal meningiomas was performed. Methods: Electronic databases were searched for all studies on spinal meningiomas dating from 2000 and onward. Findings of matching studies were pooled to strengthen the current body of evidence. Results: A total of 104 studies were included. The majority of patients were female (72.83%), elderly (peak decade: seventh), and had a world health organization (WHO) grade 1 tumor (95.7%). Interestingly, the minority of pediatric patients had a male overrepresentation (62.0% vs. 27.17%) and higher-grade tumors (33.3% vs. 4.3%). Sensory and motor dysfunction and pain were the most common presenting symptoms. Despite a handful of studies reporting promising findings associated with the use of non-surgical treatment options, the literature still suffers from contradictory results and limitations of study designs. Conclusions: Elderly females with WHO grade 1 tumors constituted the stereotypical type of patient. Compared to surgical alternatives, the evidence for the use of non-surgical treatments is still relatively weak.