NYMC Faculty Publications

Characteristics of Patients Selected for Surgical Treatment of Spinal Meningioma

Eris Spirollari, New York Medical College, Valhalla, New York, USA.
Sima Vazquez, New York Medical College, Valhalla, New York, USA.
Ankita Das, New York Medical College, Valhalla, New York, USA.
Richard Wang, New York Medical College, Valhalla, New York, USA.
Leonel Ampie, Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA.Follow
Austin B. Carpenter, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Sabrina Zeller, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Alexandria F. Naftchi, New York Medical College, Valhalla, New York, USA.
Cameron Beaudreault, New York Medical College, Valhalla, New York, USA.
Tiffany Ming, New York Medical College, Valhalla, New York, USA.
Akash Thaker, New York Medical College, Valhalla, New York, USA.
Grigori Vaserman, New York Medical College, Valhalla, New York, USA.
Eric Feldstein, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
Jose F. Dominguez, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA. Electronic address: Jose.Dominguez@wmchealth.org.
Syed Faraz Kazim, Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, New Mexico, USA.
Fawaz Al-Mufti, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow
John K. Houten, Department of Neurosurgery, Maimonides Medical Center, Northwell School of Medicine, Brooklyn, New York, USA.
Merritt D. Kinon, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1016/j.wneu.2022.06.121

Journal Title

World Neurosurgery

First Page

e680

Last Page

e688

Document Type

Article

Publication Date

9-1-2022

Department

Neurology

Second Department

Neurosurgery

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, 10 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.

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