gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Clinical and operative strategies in ventrolaterally located spinal meningiomas

Meeting Abstract

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  • N. Oezkan - Klinik für Neurochirurgie, Universitätsklinikum Essen
  • T. Schoemberg - Klinik für Neurochirurgie, Universitätsklinikum Essen
  • N. Lambertz - Klinik für Neurochirurgie, Universitätsklinikum Essen
  • S. Asgari - Neurochirurgische Klinik, Klinikum Ingolstadt
  • U. Sure - Klinik für Neurochirurgie, Universitätsklinikum Essen
  • I.E. Sandalcioglu - Klinik für Neurochirurgie, Universitätsklinikum Essen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.14.09

doi: 10.3205/12dgnc132, urn:nbn:de:0183-12dgnc1323

Published: June 4, 2012

© 2012 Oezkan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Ventrolaterally located spinal meningiomas remain a surgical challenge. We retrospectively evaluated our surgical approach and strategy for these rare lesions.

Methods: 55 patients with ventrally and ventrolaterally located spinal meningiomas underwent surgical resection between 1990 and 2010. The mean age of 11 male (20%) and 44 female patients (80%) was 64.7 years (range 17–86 years). All patients underwent pre- and postoperative neurological examination. Functional pre- and postoperative state was graded according to the Frankel scale. All patients received follow-up MRI studies. Average postoperative follow-up period was 15.9 months (1–108 months).

Results: The average preoperative duration of symptoms was 10 months (range 1–36 months). Localization of the spinal meningioma was cervical in 15 patients (27.3%), in the upper and middle thoracic spine (T1–T9) in 29 patients (52,7%) and in the lower thoracic spine (T10–L2) in 11 patients (20%). Tumour localization was ventral in 12 patients (21,8%) and ventrolateral in 43 patients (78.2%). The operative strategy and the surgical approach were planned according to the radiological findings in the MRI. Laminectomy was performed in 42 cases (76.4%), a hemilaminectomy in 4 cases (7.3%). Laminoplasties were undertaken in 9 cases (16.4%). All tumours were resected (with remnants left and coagulated at the dura) according to Simpson grade 2. At the time of the last follow-up, the neurological state improved in 43 patients (83.6%). Four patients (7.3%) showed an unchanged neurological state and 5 individuals (9.1%) deteriorated compared to their preoperative state. One radiological recurrence was documented after 5 years.

Conclusions: Meningiomas located ventrally or ventrolaterally to the spinal cord can be treated by operation with a good neurological postoperative outcome. In our series, a Simpson grade 2 (incomplete) removal was performed routinely and did not lead to an increased risk of recurrence compared to the previous literature.