Department of Orthopedic Surgery, Graduate School of Medical Sciences, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan.
Department of Orthopedic Surgery, Graduate School of Medical Sciences, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan; Department of Immunobiology and Neuroscience, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan.
J Clin Neurosci. 2021 Jan;83:68-70. doi: 10.1016/j.jocn.2020.11.026. Epub 2020 Dec 13.
Spinal meningioma is a common benign intradural spinal tumor. It has been reported that the local recurrence rate after surgical resection increases with longer follow-up duration. Simpson grade 1 resection could reduce the risk of recurrence, but this procedure needs dural reconstruction, which would cause cerebrospinal fluid (CSF) leakage or iatrogenic spinal cord injury. Saito et al. reported dura preservation technique to reduce the risk of CSF leakage, in which the meningioma together with the inner layer of the dura is removed and the outer layer is preserved for simple dural closure. The long-term outcomes with this technique have never been investigated. In this study, we retrospectively analyzed the data of 38 surgically treated patients (dura preservation technique, 12 patients; Simpson grade 2 resection, 26 patients) to assess the long-term recurrence rate (mean, 121.5 months; range, 60-228 months). The local recurrence rate in the dura preservation group was 8.3% (1 of 12 cases), which was similar to that in Simpson grade 2 resection group (2 of 26 cases [7.7%]). Although this case series did not indicate the significant difference in the recurrence rates between the dura preservation group and Simpson grade 2 group, we consider that this technique still has advantages for surgically less invasiveness in terms of dural reconstruction which is necessary for Simpson grade 1 and higher possibility of complete resection of tumors compared with Simpson grade 2 resection.
脊髓脑膜瘤是一种常见的良性硬脊膜内脊髓肿瘤。有报道称，手术切除后局部复发率随随访时间的延长而增加。Simpson 1 级切除可降低复发风险，但该手术需要硬脑膜重建，这可能导致脑脊液（CSF）漏或医源性脊髓损伤。Saito 等人报道了脑膜瘤连同硬脑膜内层一起切除，外层保留用于简单硬脑膜缝合的硬脑膜保留技术，以降低 CSF 漏的风险。该技术的长期结果从未被研究过。在这项研究中，我们回顾性分析了 38 例手术治疗患者（硬脑膜保留技术 12 例，Simpson 2 级切除 26 例）的数据，以评估长期复发率（平均 121.5 个月；范围 60-228 个月）。硬脑膜保留组的局部复发率为 8.3%（12 例中有 1 例），与 Simpson 2 级切除组（26 例中有 2 例[7.7%]）相似。尽管本病例系列未表明硬脑膜保留组和 Simpson 2 级组之间的复发率存在显著差异，但我们认为，与 Simpson 2 级切除相比，该技术在硬脑膜重建方面具有手术侵袭性较小的优势，并且更有可能完全切除肿瘤。
