Abstract：
BACKGROUND: Intramedullary meningiomas are an exceptionally rare subtype of spinal tumors, accounting for only 5% of primary spinal neoplasms. Given their scarcity and unique characteristics, understanding optimal management approaches is crucial for improved clinical decision-making. This systematic review aims to consolidate existing literature and present a detailed case illustration to enhance understanding of this uncommon spinal tumor entity.
METHODS: A systematic search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. Eligible studies included case reports, case series, cohort studies, reviews, and meta-analyses. Data extraction and synthesis focused on demographic characteristics, tumor location, clinical presentation, imaging findings, surgical interventions, histopathological features, and outcomes.
RESULTS: A total of 15 high-quality scientific articles were included in the systematic review, providing insights into various aspects of intramedullary meningiomas. Demographic analysis revealed a broad age distribution with an equal gender distribution among affected patients. Common clinical presentations included difficulty walking, sensory disturbances, spastic paraparesis, and urinary incontinence. Neuroimaging findings demonstrated heterogeneous signal intensity variations on T1- and T2-weighted images, with variable enhancement patterns on gadolinium-enhanced images. Surgical interventions, predominantly total resection, resulted in favorable postoperative outcomes in most cases.
CONCLUSIONS: Intramedullary meningiomas pose diagnostic and therapeutic challenges due to their rarity and unique characteristics. Tailored surgical approaches, incorporating techniques such as intraoperative neurophysiological monitoring and fluorescence-aided resection, are crucial for minimizing neurological deficits and optimizing patient outcomes. Despite their infrequency, recognizing intramedullary meningiomas in the differential diagnosis of spinal tumors is essential for prompt diagnosis and timely intervention, ultimately improving patient prognosis.
METHODS: A systematic search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. Eligible studies included case reports, case series, cohort studies, reviews, and meta-analyses. Data extraction and synthesis focused on demographic characteristics, tumor location, clinical presentation, imaging findings, surgical interventions, histopathological features, and outcomes.
RESULTS: A total of 15 high-quality scientific articles were included in the systematic review, providing insights into various aspects of intramedullary meningiomas. Demographic analysis revealed a broad age distribution with an equal gender distribution among affected patients. Common clinical presentations included difficulty walking, sensory disturbances, spastic paraparesis, and urinary incontinence. Neuroimaging findings demonstrated heterogeneous signal intensity variations on T1- and T2-weighted images, with variable enhancement patterns on gadolinium-enhanced images. Surgical interventions, predominantly total resection, resulted in favorable postoperative outcomes in most cases.
CONCLUSIONS: Intramedullary meningiomas pose diagnostic and therapeutic challenges due to their rarity and unique characteristics. Tailored surgical approaches, incorporating techniques such as intraoperative neurophysiological monitoring and fluorescence-aided resection, are crucial for minimizing neurological deficits and optimizing patient outcomes. Despite their infrequency, recognizing intramedullary meningiomas in the differential diagnosis of spinal tumors is essential for prompt diagnosis and timely intervention, ultimately improving patient prognosis.
摘要：
背景：髓内脑膜瘤是一种极为罕见的脊柱肿瘤亚型，仅占原发性脊柱肿瘤的5%。鉴于它们的稀缺性和独特的特征，了解最佳管理方法对于改善临床决策至关重要。本系统综述旨在巩固现有文献，并提供详细的病例说明，以增强对这种罕见脊柱肿瘤实体的理解。
方法：根据系统评价和Meta分析指南的首选报告项目进行系统检索。符合条件的研究包括病例报告，案例系列,队列研究，reviews,和荟萃分析。数据提取和综合侧重于人口特征，肿瘤位置,临床表现,影像学发现，手术干预，组织病理学特征,和结果。
结果：系统评价共纳入15篇高质量的科学文章，提供有关髓内脑膜瘤各个方面的见解。人口统计学分析显示，受影响患者的年龄分布广泛，性别分布相等。常见的临床表现包括行走困难，感觉障碍,痉挛性轻瘫,和尿失禁.神经影像学检查结果表明，T1和T2加权图像上的信号强度变化不均匀，在钆增强的图像上具有可变的增强模式。手术干预,主要是全切除，在大多数情况下导致良好的术后结局。
结论：髓内脑膜瘤由于其稀有性和独特的特点，提出了诊断和治疗的挑战。量身定制的手术方法，结合术中神经生理监测和荧光辅助切除等技术，对于减少神经功能缺损和优化患者预后至关重要。尽管他们的频率不高，在脊柱肿瘤的鉴别诊断中认识髓内脑膜瘤对于及时诊断和及时干预至关重要。最终改善患者预后。
方法：根据系统评价和Meta分析指南的首选报告项目进行系统检索。符合条件的研究包括病例报告，案例系列,队列研究，reviews,和荟萃分析。数据提取和综合侧重于人口特征，肿瘤位置,临床表现,影像学发现，手术干预，组织病理学特征,和结果。
结果：系统评价共纳入15篇高质量的科学文章，提供有关髓内脑膜瘤各个方面的见解。人口统计学分析显示，受影响患者的年龄分布广泛，性别分布相等。常见的临床表现包括行走困难，感觉障碍,痉挛性轻瘫,和尿失禁.神经影像学检查结果表明，T1和T2加权图像上的信号强度变化不均匀，在钆增强的图像上具有可变的增强模式。手术干预,主要是全切除，在大多数情况下导致良好的术后结局。
结论：髓内脑膜瘤由于其稀有性和独特的特点，提出了诊断和治疗的挑战。量身定制的手术方法，结合术中神经生理监测和荧光辅助切除等技术，对于减少神经功能缺损和优化患者预后至关重要。尽管他们的频率不高，在脊柱肿瘤的鉴别诊断中认识髓内脑膜瘤对于及时诊断和及时干预至关重要。最终改善患者预后。
