Spinal Dumbbell Meningiomas: A Systematic Review.

Aim: This systematic review aims to synthesize the epidemiology, clinical presentation, diagnostic approaches, treatment strategies, and outcomes of spinal dumbbell meningiomas to enhance understanding and improve patient management.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four major databases (PubMed, Scopus, Web of Science, and Cochrane Library) were searched until June 2024. Studies included patients diagnosed with spinal dumbbell intradural-extradural meningiomas, focusing on patient demographics, tumor characteristics, diagnostic methods, treatment modalities, and clinical outcomes. Two independent reviewers extracted the data, with discrepancies resolved by consensus or a third reviewer. Due to heterogeneity in study designs, a narrative synthesis was conducted.

Results: From 2602 studies, 22 articles comprising 32 patients met the inclusion criteria. The median patient age was 48 years (P25: 44.76, P75: 51.24), with a slight female predominance (59.38%). The cervical spine was the most common tumor location (63.63%). Symptoms included movement disorders (59.38%), sensory deficits (40.63%), and pain (34.38%). All patients underwent surgical resection, with 75% achieving gross total resection (GTR). Recurrence occurred in 15.63% of cases, and 68.75% of patients had good recovery outcomes. Histopathological analysis showed all tumors were World Health Organization (WHO) Grade I meningiomas, with meningothelial and psammomatous subtypes being most common.

Conclusions: Spinal dumbbell meningiomas are rare but challenging due to their complex anatomical features and potential for neurological deficits. Surgical resection is the primary treatment with generally favorable outcomes, but recurrence remains a concern. Long-term follow-up and research into advanced imaging and minimally invasive surgical techniques are essential for improving management and patient outcomes.