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Surgical management of ventrally located spinal meningiomas via posterior approach

  • Original Article • SPINE - TUMORS
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Spinal meningioma is a relatively common tumor among intradural extramedullary spinal tumors. When the locus of the meningioma is located on the ventral side, tumor removal, dura mater resection, and reconstruction via a posterior approach safety become technically difficult.

Methods

Twelve patients, who received surgical treatment for ventral spinal meningioma via a posterior approach, were included. There were three male and nine female patients, with an average age of 66.3 years (47–88 years). The average observation period was 55.4 months (22–132 months). In these cases, we analyzed the spinal level of tumor position, histopathological type (subtype), the grade of tumor resection (Simpson grade), pre- and post-operative walking state (Nurick grade), perioperative neurological complications, and the recurrence.

Results

Spinal meningioma occurred in the cervical spinal cord in three cases, with a further nine cases in the thoracic spinal cord. Histopathologically, all 12 tumors were assessed as grade I on the WHO classification system (eight cases of meningothelial type and four cases of psammomatous type). The level of tumor resection was Simpson grade I resection for two cases and Simpson grade II resection for the remaining ten cases. The average of Nurick grade improved from 3.3 preoperatively to 1.3 postoperatively. In all cases, we identified no neurological complications. One incident of tumor recurrence was identified 11 years after an operation involving a Simpson grade II resection

Conclusion

Posterior approaches provide adequate exposure to safely remove ventrally located meningioma. Posterior exposures with lateral bone resection, dentate ligament division, provide also adequate exposure for safe removal.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan

    Naoki Notani, Masashi Miyazaki, Shozo Kanezaki, Toshinobu Ishihara, Masanori Kawano & Hiroshi Tsumura

Authors
  1. Naoki Notani
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  2. Masashi Miyazaki
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  3. Shozo Kanezaki
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  4. Toshinobu Ishihara
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  5. Masanori Kawano
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  6. Hiroshi Tsumura
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Corresponding author

Correspondence to Masashi Miyazaki.

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The local institutional review board approved this study. All patients provided informed consent.

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Each author certifies that he or she, or a member of their immediate family, has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article.

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Notani, N., Miyazaki, M., Kanezaki, S. et al. Surgical management of ventrally located spinal meningiomas via posterior approach. Eur J Orthop Surg Traumatol 27, 181–186 (2017). https://doi.org/10.1007/s00590-016-1860-1

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  • DOI: https://doi.org/10.1007/s00590-016-1860-1

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