gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Spinal intradural meningiomas and nerve sheath tumors – Surgical results and clinical outcome

Spinale intradurale Meningeome und Nervenscheidentumore – Chirurgische Ergebnisse und klinische Verläufe

Meeting Abstract

  • corresponding author R. Goldbrunner - Neurochirurgische Klinik der Universität München
  • C. Erös - Neurochirurgische Klinik der Universität München
  • S. Zausinger - Neurochirurgische Klinik der Universität München
  • J.-C. Tonn - Neurochirurgische Klinik der Universität München

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSO.01.03

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Veröffentlicht: 11. April 2007

© 2007 Goldbrunner et al.
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Objective: Meningiomas and nerve sheath tumors (NST) represent the majority of intradural extramedullary tumors. Surgery is the primary treatment for these entities. Therefore, clinical outcome is dependent on the quality of surgical care. Aim of our study was to assess surgical results and the neurological outcome of these patients.

Methods: 93 patients (49 meningioma, 44 NST, WHO °I-IV), which were operated between 1/2002 and 10/2006, were included. Intraoperative electrophysiological monitoring (IEM) was performed routinely, intraoperative ultrasound (IOU) was used in 62% and 61%, with increasing frequency. Clinical outcome using the McCormick scale (0, no deficit – 5, completely dependent) was assessed preoperatively, one week and 6 months after surgery.

Results: Resection grade Simpson I and II was achieved in 23/26 meningiomas, in 3 cases of large thoracic meningiomas with paraparesis Simpson III was attained. In NST, complete resection was achieved in 23/27 patients. In 4 patients, tumor remnants had to be left on nerve roots to preserve function. IOU allowed exact localization before dura opening in all cases. IEM was very valuable in defining the degree of resection particularly in NST. No patient had postoperative clinical deterioration or spinal instabilty. In meningiomas, the median preoperative McCormick score was 2, which was highly significantly improved(p<0.019) after 6 months (median 1) compared to the preoperative score and the score after one week. In comparison the McCormick median score in NST patients after 6 months (1) was highly significantly improved(p<0.01) compared to preoperative median score (2).

Conclusions: Using contemporary techniques, safe tumor removal with a favourable clinical course can be accomplished in nearly any patient with an extramedullary tumor. Since preservation of function is the primary goal in these mostly benign lesions, the radicality of resection should be optimized by the use of IEM.