Yoon Sang Hoon, Chung Chun Kee, Jahng Tae Ahn
Department of Neurosurgery, Seoul National University, College of Medicine, Clinical Research Institute, Seoul, Korea.
J Korean Neurosurg Soc. 2007 Oct;42(4):300-4. doi: 10.3340/jkns.2007.42.4.300. Epub 2007 Oct 20.
We report experiences and clinical outcomes of 61 cases with spinal canal meningiomas from January 1970 through January 2005.
Thirty-eight patients were enrolled with follow-up duration of more than one year after surgery. There were 7 male and 31 female patients. The mean age was 52 years (range, 19 to 80 years). All patients underwent microsurgical resection using a posterior approach.
Twenty-nine (79.4%) cases experienced clinical improvement after surgery. The extent of tumor resection at the first operation was Simpson Grade I in 10 patients, Grade II in 17, Grade III in 4, Grade IV in 6, and unknown in one. We did not experience recurrent cases with Simpson grade I, II, or III resection. There were 6 recurrent cases, consisting of 5 cases with an extent of Simpson grade IV and one with an unknown extent. The mean duration of recurrence was 100 months after surgery. Radiation therapy was administered as a surgical adjunct in four patients (10.5%). Two cases were recurrent lesions that could not be completely resected. The other two cases were malignant meningiomas. No immediate postoperative death occurred in the patient group.
We experienced no recurrent cases of intraspinal meningiomas once gross total resection has been achieved, regardless of the control of the dural origin. Surgeons do not have to take the risk of causing complication to the control dural origin after achieving gross total resectioning of spinal canal meningioma.
我们报告了1970年1月至2005年1月期间61例椎管内脑膜瘤患者的治疗经验及临床结果。
38例患者纳入研究,术后随访时间超过1年。其中男性7例,女性31例。平均年龄52岁(范围19至80岁)。所有患者均采用后路显微手术切除。
29例(79.4%)患者术后临床症状改善。首次手术时肿瘤切除程度为辛普森一级的有10例,二级的有17例,三级的有4例,四级的有6例,1例情况不明。辛普森一级、二级或三级切除的患者未出现复发。有6例复发,其中5例为辛普森四级切除范围,1例范围不明。复发的平均时间为术后100个月。4例患者(10.5%)接受了放射治疗作为手术辅助治疗。2例为无法完全切除的复发病变。另外2例为恶性脑膜瘤。患者组未发生术后即刻死亡。
无论硬膜起源是否得到控制,一旦实现肿瘤全切,我们未遇到椎管内脑膜瘤复发的情况。在实现椎管内脑膜瘤全切后,外科医生不必冒着引起硬膜起源相关并发症的风险。