When meningiomas develop along the spinal canal, they are referred to as spinal meningioma. These benign tumors most commonly affect adults, usually around the age of 45. Women are significantly more frequently affected than men [1]. On this page we inform you about common symptoms, causes and tailored treatment concepts.
At ERCM, we offer you the benefits of modern radiosurgery, providing highly precise, reliable therapy that is especially effective in treating tumors along the entire spine. We work with the highest medical CyberKnife standard.
CyberKnife therapy is a particularly gentle treatment using a special robotic system. Learn more about it now.
Meningiomas are among the most common, mostly benign brain tumors in adults, accounting for 20 to 30% of cases. They arise from the degeneration of cells in the meninges (arachnoid membrane) and can grow both in the brain (cerebral meningiomas) and, less frequently, along the spinal canal.
Similar to a spinal neuroma, a spinal meningioma can occur anywhere along the spine. It typically grows slowly, which is why it doesn't cause symptoms for a long time. Often, months, or even years, pass from the first symptoms to diagnosis.
If meningiomas occur at a younger age, risk factors and causes such as previous radiotherapy and a familial history of the disease must also be considered [1].
The gold standard in treatment – in medicine, this refers to the best treatment options based on current scientific findings – is the removal of the benign tumor through microsurgical resection [1, 2]. Depending on the individual situation, conventional radiotherapy may follow this surgery or may be necessary.
Selected spinal meningiomas (especially smaller tumors) can often be treated effectively with the high-precision, robot-guided CyberKnife therapy. For example, if you have an increased surgical risk or do not want surgery.
Here at ERCM, with more than 2,000 patients treated with cerebral and spinal meningiomas have extensive radiosurgical experience with these mostly benign tumor diseases.
Robot-guided radiosurgical treatment can be used as initial therapy for smaller meningiomas that are difficult to remove surgically, for example, if medical reasons speak against surgery or if you as the patient do not want to undergo surgery.
Spinal meningiomas originate from cells of the middle meninges, which in turn surround the brain and spinal cord. This usually benign, oval or round tumor grows within the vertebral canal, also called the spinal canal or spinal cord canal [3]. This canal runs within the spinal column from the first cervical vertebra through the cervical, thoracic, and lumbar spine down to the sacrum.
Meningiomas may exhibit calcifications and, in rare cases, a cystic appearance [3]. If they grow in hard-to-reach areas or begin to press on blood vessels and nerves, symptoms may become increasingly severe, especially pain or sensory disturbances.
Spinal meningiomas rarely occur in children and adolescents.
In this article we discuss the possibilities of CyberKnife therapy for the treatment of spinal tumors.
Benign spinal meningiomas usually grow slowly, so obvious symptoms often linger for a long time. Over time, however, the tumors can press on the spinal cord or nerve roots (compression), impairing vital functions. Patients often suffer from local pain and various neurological symptoms.
For example, with tumors of the cervical spine, the pain can radiate into the arms, with meningiomas in the thoracic spine into the chest, or with tumors in the lumbar spine into the legs - which many patients experience in a similar way to sciatica.
Depending on the location and size of the spinal meningioma, neurological deficits are also possible.
These include, for example, as the disease progresses:
There is also a risk of myelopathy – damage to the spinal cord if the spinal canal is already severely narrowed by the meningioma [3]. Such acute compression myelopathy always represents a medical emergency [3].
If action is taken quickly and the spinal cord is effectively relieved (decompression) within the first 24 hours, this can significantly improve the prognosis with regard to further complications or neurological impairments.
If spinal cord compression is suspected, action must be taken quickly and magnetic resonance imaging must be performed for reliable medical clarification.
Exactly how and why spinal meningiomas develop is not yet fully understood. However, various factors appear to influence the occurrence and growth of these benign tumors in the spine. A connection with early trauma has been observed as a trigger for meningiomas developing later in life. However, this has not been conclusively proven scientifically [2].
The situation is different in rare cases of affected children who have previously been irradiated for a tumor disease: In these cases, several (multiple) meningiomas can occur in the further course, which unfortunately are sometimes malignant [2] .
Overall, spinal meningiomas occur significantly more frequently in women than men – with faster tumor growth, for example, during pregnancy. A connection with female sex hormones is also being discussed.
In many cases, patients affected by meningioma should not take the pill (hormonal contraceptives) or should use non-hormonal contraceptive methods (e.g., condoms) instead [2]. In this situation, we recommend individual counseling with the treating gynecologists.
Since most meningiomas do not cause symptoms for a long time, they are often discovered incidentally. Modern imaging techniques, such as computed tomography (CT) or magnetic resonance imaging (MRI), allow us to accurately identify tumors within the spinal canal.
For such examinations, the tumor is stained with a contrast agent (enhancement), which allows for an initial classification with regard to the individually appropriate therapy.
Not every spinal meningioma requires immediate treatment. The most important considerations are the size and location of the tumor. Smaller tumors hat do not impinge on sensitive structures in the spinal canal or cause no symptoms may ne able to be observed initially.
The check-up usually take place at intervals of 6 to 12 months, but always depend on the individual situation.
The treatment plan always depends on a variety of factors, including the size and location of the tumor, as well as your general health and personal preferences. As soon as you experience symptoms (e.g., pain) or neurological abnormalities—such as recurring or persistent paraesthesia—an individually tailored treatment strategy for the meningioma should be discussed and initiated.
Microsurgical surgery aims to achieve as complete a surgical removal of the spinal meningioma as possible [4]. In many cases, the tumor can be removed completely. Furthermore, approximately 80% of patients subsequently recover from previously experienced sensory deficits such as paraesthesia and gait disturbances [5].
If remnants of the tumor remain, if it was incompletely resected, or if it grows back, repeated surgical removal is possible. However, in many cases of such residual meningiomas, a follow-up CT or magnetic resonance imaging scan is recommended first, as the meningioma may sometimes cease growing for years.
Newly occurring sensory disorders in patients who have Patients who had no neurological deficits after surgery are possible after microsurgical intervention [4]. However, these problems often resolve within the first year after surgery.
Spinal meningiomas can also be treated with conventional radiation therapy. With fractionated radiation therapy, the treatment is divided into several individual sessions (fractionated) because the spinal cord and nerve roots are within the radiation field. This is intended to minimize damage to healthy tissue.
Microsurgical intervention and radiation therapy are often combined, for example, in cases of incomplete surgical removal. Affected patients may require between 10 and 25 treatment sessions over 2 to 5 weeks.
In selected cases, depending on the location and size, as well as the individual situation, the meningioma can be treated alternatively with CyberKnife therapy – this is performed on an outpatient basis and without surgical intervention. Radiosurgery with CyberKnife technology is fundamentally a highly precise and therefore reliable method for treating benign and malignant tumors throughout the body.
The Cyber Knife works with technical precision to specifically eliminate tumor cells. With submillimeter precision and a targeting accuracy of less than 1 mm, the robot-guided treatment system can target the tumor.
This innovative precision medicine makes it possible to optimally protect the sensitive structures in the area of the spinal canal and spinal cord.
There are also no complications associated with fixation or open surgery. In most cases, a single precision treatment achieves high tumor control rates of over 90%.
The actual treatment only takes about 30 minutes.
A combined treatment approach consisting of surgery followed by treatment with the CyberKnife may be necessary in various situations. For example, if complete surgical removal of critically located tumors is not safely possible, or if the spinal meningioma has already reached a size that requires surgical volume reduction as a first step—in order to subsequently treat smaller remnants with radiosurgery.
At ERCM, we will discuss with you personally in a confidential discussion whether an existing meningioma requires treatment in your individual case. All treatment decisions are always made jointly with you and the treatment team. It is important to us that you, your family, and those who support and accompany you, fully understand and can make sense of all aspects of your disease and its treatment options.
Together with our medical partners, we will accompany you on your journey and, together with our team, ensure that you feel well looked after at ERCM right from the start.
For treatment inquiries, please use the contact form. You can also reach us by phone during our opening hours or via our social media channels.
Your request will be processed individually and promptly.
In the case of growth with compression of the spinal cord, neurological deficits are a risk. In these cases, therapeutic intervention is always necessary.
The best method for diagnosis is magnetic resonance imaging with the use of contrast agents in order to optimally visualize and treat pathological changes.
A decisive factor is the location of the tumor and the question of compression of the spinal cord or nerve fibers.
An annual check-up interval is often sufficient for regular follow-up.
A spinal meningioma is a mostly benign tumor that does not affect life expectancy.
With each new generation of mobile phones, the question of long-term or intensive mobile phone use as a risk factor for the development of brain tumors is repeatedly discussed. A long-term study published in 2024 with data from more than 250,000 participants came to a clear conclusion – contrary to findings from older studies \[6\] . According to this study, even intensive mobile phone use is not associated with the risk of developing a meningioma, an acoustic neuroma, or glioma (the most common primary brain tumor).
CyberKnife radiosurgical treatment can be performed whenever there are no acute neurological deficits and no significant spinal cord compression.
CyberKnife radiosurgical therapy is painless and typically very well tolerated.
In rare cases, spinal meningiomas can regrow after surgery. In these cases, the high-precision robot-guided CyberKnife therapy represents a viable treatment alternative to repeat surgery.
[1] Seliger, C., Wick, W., Neues zur Einteilung und Therapie von Meningeomen, Neurologie up2date. 2020;03(4):343-356.
https://eref.thieme.de/ejournals/2511-3658_2020_04#/10.1055-a-0965-2007
[2] Tonn, J.C., Ryang, Y.M., Muacevic, A., Schul, D., Combs, S.E., Meningeome, in: Tumorzentrum München in Zusammenarbeit mit dem CCC München, Manual Hirntumoren und spinale Tumoren, Empfehlungen zur Diagnostik, Therapie und Nachsorge, W. Zuckschwerdt Verlag GmbH München. 2016;pp149-159. Book ISBN/EAN: 9783863712006.
[3] Laur, O., Nandu, H., Titelbaum, D.S., Nunez, D.B., Khurana, B., Nontraumatic spinal cord compression: MRI primer for emergency department radiologists, Neuroradiologie Scan. 2020;10:299-321.
https://doi.org/10.1148/rg.2019190024
[4] Gilard, V., Goia, A., Ferracci, F.X., Marguet, F., Magne, N., et al., Spinal meningioma and factors predictive of post-operative deterioration, J Neurooncol. 2018;140(1):49-54.
https://doi.org/10.1007/s11060-018-2929-y
[5] Hohenberger, C., Gugg, C., Schmidt, N.O., Zeman, F., Schebesch, K.M., Functional outcome after surgical treatment of spinal meningioma, J Clin Neurosci. 2020;77:62-66.
https://www.jocn-journal.com/article/S0967-5868(20)30881-X/abstract
[6] Feychting, M., Schüz, J., Toledano, M.B., Vermeulen, R., Auvinen, A., et al., Mobile phone use and brain tumor risk: COSMOS, a prospective cohort study, Environ Int. 2024;185:108552.
https://doi.org/10.1016/j.envint.2024.108552