Chen Hong, Fu Ya-Ni, Fu Chu-Di
Department of Orthopedics, The 903rd Hospital of Joint Logistic Support Force of People's Liberation Army, Hangzhou 310000, Zhejiang Province, China.
World J Clin Cases. 2024 Dec 26;12(36):6905-6915. doi: 10.12998/wjcc.v12.i36.6905.
Spinal meningiomas (SMs) are common benign tumors that are typically treated with surgical resection. The choice of surgical approach may vary depending on the location of dural attachment of the SM, with a posterior approach being the traditional preference. However, there is limited research available on the impact of dural attachment location on outcomes following posterior approach for SM resection.
To investigate the outcomes of posterior approach for SM resection, and compare the results among different dural attachment location subgroups.
Between January 2013 and February 2023, a total of 34 SM patients were included in the study. Various clinical and radiologic features, functional states before and after surgery, operating time, intraoperative blood loss, tumor recurrence, and perioperative complications were assessed and compared.
The average age of the included 34 patients' (10 males and 24 females) age was 62.09 years. Mean follow-up duration was 22.65 months. The location of SM was the thoracic spine in 32 cases, with only 2 in the cervical spine. On average, intraoperative blood loss was 520.59 mL, and operating time was 176.76 minutes. Thirty three cases had successful outcomes while only 1 experienced an unexpected outcome. The tumor recurrence rate was 2.9%. After surgery, there were 3 cases of cerebral spinal fluid leakage, 1 case of pneumonia, and 1 case of urinary tract infection. Dural attachments were predominantly found dorsal or dorsolateral (13 cases), followed by ventral or ventrolateral (14 cases), and lateral (7 cases). The outcomes among these subgroups were similar.
The posterior approach for SM resection is safe and effective, yielding comparable surgical and neurological outcomes regardless of the dural attachment location.
脊髓膜瘤（SMs）是常见的良性肿瘤，通常采用手术切除治疗。手术入路的选择可能因脊髓膜瘤硬脑膜附着位置的不同而有所差异，传统上更倾向于后入路。然而，关于硬脑膜附着位置对脊髓膜瘤后入路切除术后结局的影响，现有研究有限。
探讨脊髓膜瘤后入路切除术的结局，并比较不同硬脑膜附着位置亚组的结果。
2013年1月至2023年2月，共有34例脊髓膜瘤患者纳入本研究。评估并比较了各种临床和影像学特征、手术前后的功能状态、手术时间、术中出血量、肿瘤复发情况及围手术期并发症。
纳入的34例患者（10例男性，24例女性）平均年龄为62.09岁。平均随访时间为22.65个月。脊髓膜瘤位于胸椎32例，仅2例位于颈椎。平均术中出血量为520.59 mL，手术时间为176.76分钟。33例手术结果成功，仅1例出现意外结果。肿瘤复发率为2.9%。术后发生脑脊液漏3例，肺炎1例，尿路感染1例。硬脑膜附着主要位于背侧或背外侧（13例），其次是腹侧或腹外侧（14例），外侧（7例）。这些亚组的结局相似。
脊髓膜瘤后入路切除术安全有效，无论硬脑膜附着位置如何，手术和神经学结局相当。
