Barrenechea Ignacio J, Marquez Luis M, Pastor Marcelo
Department of Neurosurgery, Hospital Privado de Rosario, Argentina.
Department of Orthopedics, Sanatorio Centro, Rosario, Santa Fe, Argentina.
Surg Neurol Int. 2021 Jun 14;12:276. doi: 10.25259/SNI_383_2021. eCollection 2021.
Complete (Simpson Grade I: total removal) resections for anterior spinal meningiomas are especially challenging. This is largely attributed to difficulty obtaining a water-tight dural repair where the tumor has infiltrated the dura requiring duroplasty, thus often resulting in just a Simpson Grade II resection (i.e. coagulation of the dural implantation site). Here, we present a 56-year-old female who underwent resection of a ventral lumbar meningioma utilizing the Saito technique, that effectively separated the dura into two layers, removing just the inner layer but leaving the outer layer intact for direct dural repair.
A 56-year-old female underwent a L1-L2 laminectomy. The anterior intradural resection of tumor was achieved with the Saito technique; this required cutting circumferentially around the tumor insertion site, and removing only the inner layer.
Postoperatively, the patient did well without tumor recurrence over 8 years. The postoperative biopsy confirmed a World Health Organization Grade I meningothelial meningioma.
Saito's technique proved to be a safe and effective method for achieving gross total resection of an anterior lumbar meningioma.
对于脊髓前侧脑膜瘤进行完整切除(辛普森一级:全切)极具挑战性。这主要归因于当肿瘤浸润硬脑膜需要进行硬脑膜成形术时,难以实现水密性硬脑膜修复,因此常常只能达到辛普森二级切除(即对硬脑膜植入部位进行凝固)。在此,我们报告一位56岁女性,她接受了利用斋藤技术切除腹侧腰椎脑膜瘤的手术,该技术有效地将硬脑膜分为两层,仅切除内层,保留外层完整以进行直接硬脑膜修复。
一位56岁女性接受了L1 - L2椎板切除术。采用斋藤技术进行肿瘤的硬膜内前路切除;这需要在肿瘤植入部位周围进行环形切割,仅切除内层。
术后,患者情况良好,8年未出现肿瘤复发。术后活检证实为世界卫生组织一级脑膜内皮型脑膜瘤。
斋藤技术被证明是实现腰椎前侧脑膜瘤大体全切的一种安全有效的方法。