Spinal meningioma originates from arachnoid cap cells or fibroblasts of the dura mater. Its incidence ranks second only to schwannoma, making it the second most common intraspinal tumor. Spinal meningioma is most frequently found in the thoracic segment of the spine. The vast majority are located in the extramedullary intradural space, possess a well-defined capsule, and have a base attached to the dura mater. In rare cases, the tumor may grow beyond the dura mater. Most are solitary, though some may present as multiple or undergo malignant transformation. The peak incidence is observed in individuals aged 20 to 50 years, with 75%–85% of cases occurring in women.
Spinal meningiomas grow slowly over an extended period and gradually compress the spinal cord and/or nerve roots, leading to sensory abnormalities and pain in their innervation regions. As the tumor increases in size, it can compress and injure the spinal cord, resulting in limb weakness. MRI findings are similar to the classic imaging features of intracranial meningiomas, showing well-defined tumor margins and mild, homogeneous enhancement in contrast imaging, with the presence of the "dural tail sign." On CT scans, the tumor is typically seen as isodense or slightly hyperdense, with some cases showing calcifications. Surgical resection generally produces good outcomes.