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Meningiomas (spinal)

Spinal Meningioma: A Treatable Tumor of the Spinal Cord Lining

A spinal meningioma can slowly cause numbness, weakness or trouble walking that’s easy to blame on age or arthritis. The good news: nearly all spinal meningiomas are benign, and surgery can often remove them completely.

What Is a Spinal Meningioma?

A meningioma is a tumor that grows from the meninges, the thin layers of tissue that cover the brain and spinal cord. In the spine, meningiomas grow inside the protective sac (dura) but outside the spinal cord, so they are called intradural-extramedullary tumors. As they slowly enlarge, they press on the spinal cord or nerve roots.

Illustration of a cross-section of the spine showing where extradural, intradural-extramedullary and intramedullary tumors grow
Image: Nadezdha D. Kiriyak, CC BY 4.0 (source)

Spinal meningiomas are one of the most common tumors inside the spinal canal. They occur most often in the thoracic (mid-back) spine and are much more common in women, typically in middle age and later. More than 90% are benign (WHO grade 1).

Symptoms

Common symptoms

  • Back pain, often worse at night
  • Numbness or tingling in the legs or trunk
  • Leg weakness, stiffness or heaviness
  • Trouble with balance or walking

Symptoms patients often ignore

  • A band of numbness or tingling around the chest or abdomen
  • Slowly worsening balance blamed on age
  • Bladder urgency or changes
  • Hand clumsiness, if the tumor is in the neck

When it’s an emergency: Rapidly worsening weakness, numbness in the groin, or bladder or bowel changes need emergency care. Call 911 or go to the nearest emergency room.

Causes and Risk Factors

  • Female sex
  • Middle age and older
  • Neurofibromatosis type 2 (NF2)
  • Prior radiation exposure

In most people, there is no known cause.

How We Diagnose a Spinal Meningioma

  • Neurological exam: strength, sensation, reflexes, balance and walking
  • MRI with contrast: shows the tumor, which typically enhances brightly and is attached to the dura
  • CT scan: can show calcium in the tumor, which helps with surgical planning
MRI of the thoracic spine showing a meningioma inside the spinal canal pressing on the spinal cord
Image: Hellerhoff, CC BY-SA 3.0 (source)

Treatment Options

Observation

Small meningiomas found by chance that aren’t causing symptoms can often be monitored with periodic MRI scans.

When surgery makes sense

Surgery is recommended for meningiomas that cause symptoms or are growing. In most cases, surgery can remove the entire tumor and correct the problem. Using a microscope and nerve monitoring, the tumor is carefully separated from the spinal cord and removed along with its attachment to the dura (spinal cord tumor resection). Many patients see steady improvement in walking and sensation afterward.

Radiation

Radiation may be considered for tumors that can’t be completely removed, that come back, or in patients who can’t have surgery.

Why Choose Dr. Betsy Grunch for Spinal Meningioma

  • Duke-trained: neurosurgical residency and spine research fellowship at Duke University School of Medicine, where she received the Spine Young Investigator Award
  • Experience you can count on: in practice since 2013, performing 400 to 600 surgeries a year and more than 5,000 procedures over her career
  • Precise, protective surgery: microsurgical technique with nerve monitoring to protect spinal cord function
  • The right treatment for you: board-certified (FAANS, FACS, FCNS), she starts with the least invasive option that will work, and recommends surgery when it can correct the problem
  • Clear answers: known online as Ladyspinedoc, she makes sure you understand your imaging and every option in front of you

What to Expect If You Need Surgery

Before surgery

You’ll meet with Dr. Grunch or one of her physician assistants to review your MRI and plan the procedure. Our team coordinates pre-operative testing and reviews your medications.

Procedure day

Surgery typically takes a few hours. Most patients stay in the hospital for a few days.

Recovery timeline

  • Days 1-3: walking with help
  • Weeks 1-6: gradual increase in activity; avoid heavy lifting and bending
  • Weeks 6-12: physical therapy and return to most activities as cleared
  • Months: strength, balance and sensation can continue to improve; follow-up MRI scans monitor for regrowth

Frequently Asked Questions

Is a spinal meningioma cancer?

Almost always no. More than 90% of spinal meningiomas are benign.

Can it be completely removed?

In most cases, yes. Complete removal gives the best long-term result.

Will I walk normally again?

Many patients improve significantly after surgery, especially when the tumor is removed before severe weakness develops.

Can it come back?

Recurrence after complete removal is uncommon, but follow-up MRI scans are recommended.

Is a spinal meningioma the same as a brain meningioma?

They are the same type of tumor in a different location. Learn more about meningiomas of the brain.

Take the Next Step

Hearing that you have a spinal tumor is frightening. Whether you need a diagnosis, a treatment plan or a second opinion, Dr. Grunch and the Southern Neurosurgery team are here to help you understand your options.

Call 470-293-9800 to schedule an appointment or contact us online.

Have a question first? Ask our virtual assistant anything, 24/7.

We see patients across metro Atlanta and North Georgia at our offices in Gainesville, Sandy Springs and South Atlanta (Riverdale). Find the office nearest you.

This page is for educational purposes only and is not a substitute for medical advice. If you have sudden weakness, numbness in the groin, or bladder or bowel changes, call 911 or go to the nearest emergency room.