Artikel
Clinical and operative strategies in ventrolaterally located spinal meningiomas
Suche in Medline nach
Autoren
-
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
| Veröffentlicht: | 4. Juni 2012 |
|---|
Gliederung
Text
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.
