Ucler Necati, Hergunsel Batu, Ozturk Sait, Kozan Serpil, Kaplan Metin
Adiyaman University, Department of Neurosurgey, Adiyaman, Turkey.
Turk Neurosurg. 2018;28(6):979-982. doi: 10.5137/1019-5149.JTN.22416-17.2.
To evaluate postoperative clinical outcome and recurrence rates in cases with ventrally located spinal meningiomas who underwent Simpson grade 2 resection.
We evaluated eight cases (six females and two males; age, 28?86 years; mean age, 60 years) with ventrally located spinal meningioma that underwent surgical treatment in our clinic. The tumors were located in the thoracic region in seven cases and in the cervical region in one case. All cases underwent surgery, which was performed using a traditional posterior midline approach. Laminectomy was unilaterally extended. The case with cervically located tumor differed from the other cases in that a skull clamp was used and laminoplasty was performed.
The tumor was completely resected in all cases. Furthermore, in all cases, the tumor nidus that caused the thickening of the dura was cauterized using bipolar cautery and peeled off (Simpson grade 2). The pathological examination of the tumor specimens revealed typical grade 1 meningioma in all cases (fibropsammomatous type, n=1; meningothelial type, n=3; and psammomatous type, n=4). Recurrence was not observed in any of the cases during the follow-up. None of the cases demonstrated postoperative neurological deterioration. At 1 month postoperatively, pain and motor deficit completely improved in all cases, with remarkable improvements of motor deficits in the early postoperative period.
Simpson grade 2 resection in ventrally located spinal meningiomas results in low complication rates and is satisfactory in terms of recurrence.
评估经辛普森2级切除的腹侧脊髓脑膜瘤患者的术后临床结局和复发率。
我们评估了8例（6例女性和2例男性；年龄28 - 86岁；平均年龄60岁）在我院接受手术治疗的腹侧脊髓脑膜瘤患者。7例肿瘤位于胸段，1例位于颈段。所有病例均接受手术，采用传统后正中入路。椎板切除术单侧扩大。颈段肿瘤病例与其他病例的不同之处在于使用了颅骨夹并进行了椎板成形术。
所有病例肿瘤均完全切除。此外，所有病例均使用双极电凝烧灼并剥离导致硬脑膜增厚的肿瘤巢（辛普森2级）。肿瘤标本的病理检查显示所有病例均为典型的1级脑膜瘤（纤维砂粒体型，n = 1；脑膜内皮型，n = 3；砂粒体型，n = 4）。随访期间所有病例均未观察到复发。所有病例均未出现术后神经功能恶化。术后1个月，所有病例的疼痛和运动功能障碍完全改善，术后早期运动功能障碍有显著改善。
腹侧脊髓脑膜瘤的辛普森2级切除并发症发生率低，复发情况令人满意。
