Trap-door durotomy for ventral calcified thoracic meningioma

Medical Communication Services after Traumatic Spinal Cord Injury

“…A case report by Dickerman et al treated by durotomy showed full recovery after eight weeks; CSF leakage was not detected [ 11 ]. Furthermore, Perkins and Deane observed six cases that underwent durotomy, half of whom recovered fully, whereas the other half recovered only partially [ 3 ].…”

“…The underlying arachnoid after durotomy becomes pulsatile, intact, and undisturbed. “Trap-door” durotomy allows safer exposure to access the ventral spinal cord with excellent visualization and better evacuation of hematomas, but dural incision of durotomy and duroplasty is a high-risk surgical procedure [ 11 ]. Moreover, paralysis after myelotomy can be the result of fault technique through cutting the cord or secondary inflammatory changes [ 50 ].…”

Letter: Ventral Subaxial Cervical Access Using Tailored Access Osteotomies, A Cadaveric Study

“…We published an article on approaching ventral thoracic calcified meningiomas in the upper thoracic spine. 2 We wanted to offer a surgical technique that may assist surgeons on their exposure to ventral tumors. Scullen et al 1 performed a standard midline durotomy, followed by release of the dentate ligaments, unilaterally or bilaterally.…”

“…This trap-door durotomy technique was developed out of necessity for exposure because the patient we were working on had a BMI >50 with a large calcified ventral tumor. 2 Although the far lateral bony exposure is the primary step to obtain safe angles to the tumor, a midline durotomy can still be a restrictive component. We found that even with tight dura tack-ups, we could not get sufficient visualization.…”

In Reply: Ventral Subaxial Cervical Access Using Tailored Access Osteotomies, A Cadaveric Study

“…2 The described approach uses lateral cuts at the cranial and caudal extents of a midline durotomy to increase visualization of the ventral space, as illustrated in their referenced case involving the safe resection of a proximal thoracic meningioma using a three-level laminectomy and unilateral transpedicular approach with costotomy. 3…”