• Hidehiro Okura, Omar N Pathmanaban, David G Munoz, and Michael D Cusimano.
• Division of Neurosurgery, St Michael's Hospital, University of Toronto, Toronto, Canada.
• World Neurosurg. 2022 Jan 1; 157: 48-53.

ObjectiveSpinal meningiomas are one of the frequently seen intradural extramedullary spinal tumors. They are almost always World Health Organization grade I, and a complete removal of the tumor can be curative. However, ventrally located spinal meningioma removal can be challenging due to the position in front of the spinal cord through a narrow corridor provided by routine dorsal approaches. Incomplete excision of the relatively inaccessible dural attachment can consequently lead to recurrence. We describe a safe and reproducible technique used to achieve Simpson grade I removal of ventrally located spinal meningioma.MethodsSince the spinal dura can be easily divided into inner and outer layers and the tumor usually spares the outer layer, we developed a simple technique to achieve total resection of the tumor and involved dura while leaving the outer dural layer intact.ResultsAn advantage of this procedure is that it exploits an interdural approach to allow early devascularization of the tumor without cord manipulation and provides access to the ventral dura to achieve Simpson grade I excision. Another advantage is complete dural closure to minimize postoperative cerebrospinal fluid leak or ventral cord herniation without the need for dural substitutes.ConclusionIts novel interdural approach can be used for all ages and all spinal meningiomas.Copyright © 2021. Published by Elsevier Inc.

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