Characteristics of Patients Selected for Surgical Treatment of Spinal Meningioma

Eris Spirollari, Sima Vazquez, Ankita Das, Richard Wang, Leonel Ampie, Austin B. Carpenter, Sabrina Zeller, Alexandria F. Naftchi, Cameron Beaudreault, Tiffany Ming, Akash Thaker, Grigori Vaserman, Eric Feldstein, Jose F. Dominguez, Syed Faraz Kazim, Fawaz Al-Mufti, John K. Houten, Merritt D. Kinon

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Spinal meningiomas are benign extra-axial tumors that can present with neurological deficits. Treatment partly depends on the degree of disability as there is no agreed-upon patient selection algorithm at present. We aimed to elucidate general patient selection patterns in patients undergoing surgery for spinal meningioma. Methods: Data for patients with spinal tumors admitted between 2016 and 2019 were extracted from the U.S. Nationwide Inpatient Sample. We identified patients with a primary diagnosis of spinal meningioma (using International Classification of Disease, 10th revision codes) and divided them into surgical and nonsurgical treatment groups. Patient characteristics were evaluated for intergroup differences. Results: Of 6395 patients with spinal meningioma, 5845 (91.4%) underwent surgery. Advanced age, nonwhite race, obesity, diabetes mellitus, chronic renal failure, and anticoagulant/antiplatelet use were less prevalent in the surgical group (all P < 0.001). The only positive predictor of surgical treatment was elective admission status (odds ratio, 3.166; P < 0.001); negative predictors were low income, Medicaid insurance, anxiety, obesity, and plegia. Patients with bowel–bladder dysfunction, plegia, or radiculopathy were less likely to undergo surgical treatment. The surgery group was less likely to experience certain complications (deep vein thrombosis, P < 0.001; pulmonary embolism, P = 0.002). Increased total hospital charges were associated with nonwhite race, diabetes, depression, obesity, myelopathy, plegia, and surgery. Conclusions: Patients treated surgically had a decreased incidence of complications, comorbidities, and Medicaid payer status. A pattern of increased utilization of health care resources and spending was also observed in the surgery group. The results indicate a potentially underserved population of patients with spinal meningioma.

Original languageEnglish
JournalWorld Neurosurgery
DOIs
StatePublished - Sep 2022
Externally publishedYes

Keywords

  • Benign
  • Meningioma
  • Predictor
  • Spinal cord neoplasms
  • Surgery

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