Spinal meningioma

A spinal meningioma arises from cells in the meninges, the coverings around the spinal cord. Usually slow-growing and low-grade, it can compress the cord without initially invading cord tissue and may cause gradually progressive neurological difficulties despite its relatively favourable biological behaviour.

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A tumour of the cord coverings

A spinal meningioma usually lies inside the dura but outside spinal cord tissue. The thoracic region is commonly involved. Grade describes biological behaviour; even a low-grade lesion can become clinically important because of the space it occupies next to the spinal cord.

Manifestations and emergencies

Local pain, stiff legs, numbness and walking difficulty may develop gradually. A sensory change below a particular level can help guide the examination. Rapidly worsening weakness, new inability to walk, urinary retention or loss of bladder or bowel control requires immediate emergency assessment.

Diagnosis

Contrast-enhanced MRI shows the mass and its relationship to the cord. Pathological examination establishes the tumour type and grade when tissue is removed. The differential diagnosis includes schwannoma and other intradural masses. Walking ability and neurological findings provide a baseline against which subsequent change can be assessed.

Treatment and outlook

Observation may be considered for selected lesions causing few symptoms. Compression or progression often leads to consideration of surgery. Radiotherapy may be appropriate depending on grade, remaining tumour or recurrence. Recovery partly depends on neurological function before treatment; long-term follow-up remains important even after an initially favourable result.

Role of TAGMED care

Neurosurgical management takes priority. TAGMED does not treat the tumour or alter its biological grade. After stabilization, support for musculoskeletal problems can be discussed with the medical team. Traction or manipulation must not be used as an attempt to directly decompress the tumour itself.

Frequently asked questions

Is this always an aggressive cancer?

No. Many spinal meningiomas are low-grade tumours.

Why can a benign tumour affect walking?

There is limited space around the spinal cord within the canal.

Does MRI give the final grade?

No. Tissue examination is needed for that classification.

Is surgery the only possible approach?

No. Surveillance or radiotherapy may be considered in particular circumstances.

Can it recur?

Yes. Follow-up is tailored to the grade, treatment and individual findings.

Educational information from The Spine Page. This entry does not replace an individual assessment. Documentary version: October 12, 2026. Sylvain Desforges, B.Sc., D.O., N.D., osteopath and naturopath.