A less invasive surgical concept for the resection of spinal meningiomas

Boström, Azize; Bürgel, Uli; Reinacher, Peter C.; Krings, Timo; Rohde, Veit; Gilsbach, Joachim M.; Hans, Franz-Josef

doi:10.1007/s00701-008-1514-0

Cited by 53 publications

(57 citation statements)

References 10 publications

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“…61 The high rate of favorable clinical results combined with the low rate of recurrences supports less aggressive surgeries for treating spinal meningiomas, as resection of the dural matrix is not the aim. 9 Patients older than 50 years benefited moderately from surgery; 5% required reoperation for residual or recurrent tumor compared with 22% of those younger than 50 years. 17 Resection of a single eloquent nerve root involved in a nerve sheath tumor is the main risk factor related to recurrence.…”

Section: Discussionmentioning

confidence: 99%

Quality of life in adult intradural primary spinal tumors: 36-Item Short Form Health Survey correlation with McCormick and Aminoff-Logue scales

Guirado

Taricco

Nobre³

et al. 2013

SPI

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Object The most appropriate method to determine the quality of life of patients with intradural primary spinal tumors (IPSTs) is not still well established. Methods Clinical data in 234 patients who underwent surgery for intradural spinal disease were collected prospectively. The 36-Item Short Form Health Survey (SF-36), a generic score scale, was administered to 148 patients with IPSTs to demonstrate if the survey can be used to effectively evaluate these patients. Forty-eight patients were excluded because they did not complete the protocol. The study was finally conducted with 100 patients (45 male and 55 female) with IPSTs, and the results were compared with those of 2 other scales: the McCormick scale and the Aminoff-Logue scale. Results Construct validity was demonstrated by confirming the hypothesized relationship between the scores of the SF-36 and the McCormick scale (p = 0.003), the Aminoff-Logue gait subscale (p = 0.025), the Aminoff-Logue micturition subscale (p = 0.013), and the Aminoff-Logue defecation subscale (p = 0.004). Reliability was demonstrated for all 8 SF-36 domain scales and the Physical Component Summary and the Mental Component Summary of the SF-36, where in each the Cronbach alpha satisfied the Nunnally criterion of > 0.85. Conclusions The authors' results demonstrated that SF-36 provides valid and reliable data for patients with IPSTs and that the survey can be used appropriately to evaluate these patients.

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Section: Discussionmentioning

confidence: 99%

Quality of life in adult intradural primary spinal tumors: 36-Item Short Form Health Survey correlation with McCormick and Aminoff-Logue scales

Guirado

Taricco

Nobre³

et al. 2013

SPI

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“…Patients with spinal meningiomas may experience recurrence of tumor. Boström et al (2008) argued that the high rate of favorable clinical results combined with the low rate of recurrences supported the less invasive surgical concept, which did not aim for resection of the dural matrix of the spinal meningioma.…”

Section: Technical Requirements Of the Limited Approachmentioning

confidence: 99%

Unilateral hemilaminectomy for patients with intradural extramedullary tumors

Sun

Meng

Xie

et al. 2011

J. Zhejiang Univ. Sci. B

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Abstract:A modified hemilaminectomy was introduced in an attempt to explore the operative techniques and the values of the limited approach to spinal cord tumors. Forty-five consecutive patients with intradural extramedullary lesions, who underwent modified hemilaminectomy, were studied retrospectively. The intraspinal tumors were removed via the limited bone window with a 3.3-cm mean length (range: 2.0-6.5 cm) and a 1.2-cm mean width (range: 0.6-1.5 cm), in which the inner parts of the medial and lateral laminae were mostly undercut for wider view. Spinal lesions were cervical in 21 cases, thoracic in 12 cases, lumbar in 10 cases, and multiple in 2 cases. Forty-three cases were completely excised via hemilaminectomy alone. Two subjects with dumbbell neurinoma underwent two-stage tumor removal via anterolateral cervical approach following hemilaminectomy. With respect to neurological status, the percentage of good Frankel scale (D+E grade) was markedly improved from 22.2% on admission to 93.3% at follow-up. At the median 26-month follow-up evaluation by magnetic resonance imaging (MRI), none of the subjects showed spinal deformity or instability. By preserving musculoligamentous attachments and posterior bony elements as much as possible, the modified approach is minimally invasive and may be routinely used to remove intradural and extramedullary tumors, especially in patients with meningiomas and neurinomas.

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“…For intracranial and intraspinal meningiomas, tumor recurrence may be prevented by total removal of the tumor and dural attachment (1,2). However, if the dural attachment of intraspinal meningiomas is located ventrally, laterally or dorsal-laterally, cauterizing the dura takes priority over dural resection, preventing post operative cerebrospinal fluid leak or cord damage (4). Although the neurological function of our patient was deteriorated following surgery, the symptoms were improved to normal levels within six months, and no tumor recurrence was noted.…”

Section: Discussionmentioning

confidence: 66%

“…AMs also occasionally occur in the spinal canal, and account for 1% of all intraspinal meningiomas (2). The majority of spinal AMs are located in the intradural-extramedullary (IDEM) space (4,5). Compared with other IDEM tumors, intraspinal AMs have no unique clinical symptoms (2).…”

Section: Introductionmentioning

confidence: 99%

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Epidural angiomatous meningioma of the thoracic spine: A case report

Yang

et al. 2015

Oncology Letters

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Abstract. Spinal epidural angiomatous meningiomas (AMs) are extremely rare lesions. Here, we report on a case of an epidural AM of the thoracic spine with chronic but severe cord compression. The patient underwent a T6-T8 laminectomy through the posterior approach. En bloc resection was achieved, and histopathological examination demonstrated an AM. Delayed paraplegia occurred 4 h postoperatively. The patient was treated with methylprednisolone, hyperbaric oxygen and rehabilitation. Gradually, over the next six months, the bilateral leg strength was improved compared with the preoperative status, and no tumor recurrence was noted. Although epidural AM is extremely rare, it should be included in the differential diagnosis of spinal epidural lesions. A definitive diagnosis is difficult based on magnetic resonance imaging alone due to the nonspecific characteristics of the tumor. Since AM is a histologically benign and highly vascularized tumor, timely gross total resection (GTR) is the most effective treatment. A good clinical outcome may be expected following GTR (Simpson grade I and II resection).

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A less invasive surgical concept for the resection of spinal meningiomas

Abstract: The high rate of favourable clinical results combined with the low rate of recurrences supports our less invasive surgical concept, which does not aim for resection of the dural matrix of the spinal meningioma.

Cited by 53 publications

References 10 publications

Quality of life in adult intradural primary spinal tumors: 36-Item Short Form Health Survey correlation with McCormick and Aminoff-Logue scales

Quality of life in adult intradural primary spinal tumors: 36-Item Short Form Health Survey correlation with McCormick and Aminoff-Logue scales

Unilateral hemilaminectomy for patients with intradural extramedullary tumors

Epidural angiomatous meningioma of the thoracic spine: A case report

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