Orientation and Emergency Warning Signs for Spinal Meningioma

Finding out you have a tumor near your spinal cord is a frightening experience. However, it is important to know that spinal meningiomas—tumors that grow from the protective lining (the meninges) of the spinal cord—are typically slow-growing and benign ^[1][2].

While the word “tumor” is alarming, more than 90% to 95% of these are classified as WHO Grade 1 in surgical registries, which means they are non-cancerous and do not typically spread to other parts of the body ^[3]. However, “benign” does not mean harmless; because they take up space, they can cause serious neurological damage if left untreated. Because they grow so slowly, many people have them for a long time before they ever cause symptoms ^[1].

Understanding Your Diagnosis

Spinal meningiomas are rare, occurring in roughly 0.2 to 0.4 out of every 100,000 people each year depending on the registry studied ^[4][5]. They most frequently develop in the thoracic spine (the middle back) and are much more common in women than men, with a ratio of approximately 4 to 1 to 5 to 1 ^[6][7]. They are most often diagnosed in adults between the ages of 60 and 84, though they can happen at other ages ^[4][8].

Unlike some other tumors that grow inside the spinal cord, a meningioma usually grows next to it, within the spinal canal. As it grows, it can begin to push against the spinal cord or nearby nerves. This pressure—not the tumor itself—is what causes physical symptoms ^[2].

When to Seek Emergency Care

Most spinal meningiomas cause gradual changes, such as mild numbness or a slow change in how you walk. These are not typically emergencies. However, if the tumor reaches a point where it severely or suddenly compresses the spinal cord, it can cause acute spinal cord compression. This is a medical emergency that requires immediate evaluation to prevent permanent nerve damage ^[9][10].

Go to an Emergency Room immediately if you experience:

• Sudden or Rapidly Worsening Weakness: If your legs or arms feel heavy, weak, or “give out” suddenly, or if you lose the ability to move a limb ^[9][11].
• New Loss of Bladder or Bowel Control: This may include a sudden inability to pass urine, an inability to tell when your bladder is full, or accidental bowel movements ^[9][11].
• Rapidly Progressing Paralysis: Any loss of movement that spreads or worsens over hours or a few days (weakness in both legs or all four limbs) ^[9][12].
• Profound Difficulty Walking: A sudden change in your balance that makes walking unsafe or impossible without help ^[11].
• Severe, Escalating Pain: Intense spinal pain that is rapidly getting worse and is not relieved by rest or position changes ^[9].

What is Not an Emergency?

While every symptom should be reported to your doctor, stable, chronic symptoms are generally not considered medical emergencies unless they suddenly become much worse. However, you should contact your treating clinician promptly (call today) for any new or steadily worsening gait problems, weakness, or numbness.

Biological Behavior and Grading

Meningiomas are graded by the World Health Organization (WHO) to describe how they are likely to behave. Note that WHO grade is established from pathology after tissue is removed, not from the initial MRI. Spinal meningiomas are notably more likely to be benign than those found in the brain ^[13].

• WHO Grade 1 (Benign): Approximately 95% of spinal meningiomas fall into this category in many studies ^[3]. They grow slowly and have a low risk of coming back after they are surgically removed.
• WHO Grade 2 (Atypical): These account for a small percentage of cases ^[14]. They may grow slightly faster and require more frequent monitoring.
• WHO Grade 3 (Malignant/Anaplastic): These are very rare, making up only about 1% to 2% of spinal cases ^[14].

Because these tumors are usually slow-moving, your medical team typically has time to carefully plan the best approach for you. The goal of treatment is typically to relieve the pressure on your spinal cord and protect your mobility ^[11][15].