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

Spinal Cord (2025)Cite this article

Subjects

Abstract

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.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

In preparing this manuscript, ChatGPT (OpenAI) and Grammarly (Grammarly Inc.) were used to refine grammar and correct typographical errors. These tools were used solely to enhance clarity and readability without altering the scientific content or interpretation of the findings.

Funding

This study received no financial support for this research, authorship, and publication of this article.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan

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

  2. Keio Spine Research Group (KSRG), Tokyo, Japan

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

  3. Department of Orthopaedic Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan

    Yu Suematsu

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  1. Yu Suematsu
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  2. Narihito Nagoshi
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Contributions

YS contributed to the data collection, data analysis, data interpretation and preparation of the initial draft of the manuscript. NN contributed to the study design, data analysis, data interpretation, and assistance with manuscript preparation. TO, MO, SS, KT, TI were responsible for the data collection and interpretation of the results. MM, MN, KW were responsible for the interpretation of the results, and supervision of the manuscript. All authors critically reviewed and approved the final version.

Corresponding author

Correspondence to Narihito Nagoshi.

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Competing interests

The authors declare no competing interests.

Ethics Approval and Consent to Participate

This study received ethical approval from the institutional review board of the Ethics Committee of the Keio University School of Medicine (20110142). We certify that all applicable institutional regulations concerning the ethical use of human volunteers were followed during the research.

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Suematsu, Y., Nagoshi, N., Okubo, T. et al. Comparison of surgical and clinical outcomes between ventral and dorsal/lateral thoracic intradural extramedullary meningiomas: a retrospective study. Spinal Cord (2025). https://doi.org/10.1038/s41393-025-01132-7

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