TY - JOUR
T1 - Anterior Microsurgical Approach to Ventral Lower Cervical Spine Meningiomas
T2 - Indications, Surgical Technique and Long Term Outcome
AU - Fraioli, Mario F.
AU - Marciani, Maria G.
AU - Umana, Giuseppe E.
AU - Fraioli, Bernardo
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Ventral lower cervical spinal meningiomas with posterior displacement of the spinal cord are rare and anterior approach has been rarely reported in the literature. The authors present their experience about eight patients operated through anterior microsurgical approach. Exposure of meningiomas was achieved through one or two corpectomies, according to meningioma extension. Tumour removal was performed thanks to the aid of a dedicated ultrasonic aspirator, and intraoperative evoked potentials were employed. Particular care was taken with the materials adopted for reconstruction of the anterior dural plane, to avoid postoperative cerebrospinal fluid leak. Vertebral fusion and stabilization were achieved by tantalum cage or titanium graft in case of one or two corpectomies respectively; anterior titanium plate fixed with screws was applied in all patients. Extent of tumour removal was related to the presence of a conserved arachnoidal plane between the tumour and the spinal cord: total removal was achieved in 2 patients, while gross total removal in the other six ones. Postoperative neurological outcome, which was favourable in all patients, was related mostly to preoperative neurologic status. No recurrence after total removal and no remnant growth after gross total removal occurred during an average follow-up period of 6, 7 years.
AB - Ventral lower cervical spinal meningiomas with posterior displacement of the spinal cord are rare and anterior approach has been rarely reported in the literature. The authors present their experience about eight patients operated through anterior microsurgical approach. Exposure of meningiomas was achieved through one or two corpectomies, according to meningioma extension. Tumour removal was performed thanks to the aid of a dedicated ultrasonic aspirator, and intraoperative evoked potentials were employed. Particular care was taken with the materials adopted for reconstruction of the anterior dural plane, to avoid postoperative cerebrospinal fluid leak. Vertebral fusion and stabilization were achieved by tantalum cage or titanium graft in case of one or two corpectomies respectively; anterior titanium plate fixed with screws was applied in all patients. Extent of tumour removal was related to the presence of a conserved arachnoidal plane between the tumour and the spinal cord: total removal was achieved in 2 patients, while gross total removal in the other six ones. Postoperative neurological outcome, which was favourable in all patients, was related mostly to preoperative neurologic status. No recurrence after total removal and no remnant growth after gross total removal occurred during an average follow-up period of 6, 7 years.
KW - Anterior Approach
KW - Dural Plane Reconstruction
KW - Lower Cervical Spine Meningioma
KW - Ventral Cervical Spine Meningioma
UR - http://www.scopus.com/inward/record.url?scp=84973424363&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84973424363&partnerID=8YFLogxK
U2 - 10.1177/1533034614500418
DO - 10.1177/1533034614500418
M3 - Article
C2 - 26269613
VL - 14
SP - 505
EP - 510
JO - Technology in Cancer Research and Treatment
JF - Technology in Cancer Research and Treatment
SN - 1533-0346
IS - 4
ER -