• World Neurosurg · Apr 2022

    Surgical Resection of Dorsal Spinal Meningiomas with the Inner Dura Layer-An Improved Preservation Technique of Spinal Dura in 40 Cases.

    • Xiaoxiong Wang, Jiabin Wang, Liankun Wang, Yongdong Lin, Mingchun Yang, Xiaoli Chen, Lei Teng, Hua Guo, and Xiaofeng Chen.
    • Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China; Institute of Brain Science, Harbin Medical University, Harbin, People's Republic of China; Institute of Neuroscience, Sino-Russian Medical Research Center, Harbin Medical University, Harbin, People's Republic of China.
    • World Neurosurg. 2022 Apr 1; 160: e250-e255.

    BackgroundSpinal meningiomas are the common benign tumors in intradural extramedullary spinal tumors. Simpson grade I resection is recommended to avoid tumor recurrence. However, the dura reconstruction increases a risk of cerebrospinal fluid leakage after this surgical resection. To address this concern, the inner dura layer resection and long-term surgical outcomes of this technique were designed and examined after total tumor resection to preserve the outer dura layer.MethodsThis study included 40 spinal meningioma patients undergoing the outer dura layer resection between 2002 and 2019. Clinical characteristics, radiologic features, preoperative and postoperative functional states, tumor recurrence, and perioperative complications were described and evaluated.ResultsA total of 40 spinal meningioma cases with the median age of 63 years (36-81 years) were enrolled in this study. The median postoperative follow-up period of all 40 cases was 96 months (34-193 months). About 82.5% of cases were located in the thoracic spine, while 16.5% of cases were located in the cervical spine. Of the symptomatic cases, 87.5% of cases follow with satisfactory outcomes and 12.5% of cases follow with unexpected outcomes. The local spinal meningioma recurrence rate was 2.5% (1 of 40 cases). No postoperative cerebrospinal fluid leak occurred in the 40 spinal meningioma cases.ConclusionsA long-term postoperative follow-up indicated that this modified spinal dura preservation technique caused good neurologic improvement with rare recurrence. Therefore we recommend this improved technique may be an alternative surgical option for total resection of spinal meningiomas with favorable prognosis.Copyright © 2022 Elsevier Inc. All rights reserved.

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