Hirschmann D, Hölz M, Kucinska G, Hofbauer M, Herta J, Millesi M
Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
World Neurosurg. 2025 May;197:123857. doi: 10.1016/j.wneu.2025.123857. Epub 2025 Mar 5.
To evaluate the risk of tumor relapse after Simpson grade 1 resection of spinal meningiomas compared to other Simpson grades. Furthermore, to evaluate incidence of cerebrospinal fluid (CSF) leak after resection of affected dura and use of a patch for dural repair.
We retrospectively analyzed a consecutive series of patients who underwent resection of a spinal meningioma at our department between 1980 and 2020.
Overall, 153 patients were included, and Simpson grade 1, 2, 3, and 4 resection was achieved in 13%, 75%, 9%, and 3%, respectively. The median time of radiologic follow-up was 28.5 (1-261) months. Tumor relapse occurred in a total of 8 patients (5.2%) after a median time of 54.5 (22-219) months and was significantly associated with Simpson grade (P = 0.004). CSF leaks occurred in a total of 5 patients and were not associated with dural resection and use of a patch for dural repair compared to primary dural suture (P = 0.470).
Gross total resection including the affected dura may reduce the risk of tumor relapse and is not associated with a higher rate of CSF leaks in dorsal spinal meningiomas. Resection of only the inner dural layer is a valid alternative to achieve Simpson 1 resection.
评估与其他辛普森分级相比，辛普森1级切除脊髓脑膜瘤后肿瘤复发的风险。此外，评估切除受影响硬脑膜后脑脊液（CSF）漏的发生率以及使用补片进行硬脑膜修复的情况。
我们回顾性分析了1980年至2020年间在我科接受脊髓脑膜瘤切除术的一系列连续患者。
总体上，纳入了153例患者，辛普森1级、2级、3级和4级切除分别占13%、75%、9%和3%。影像学随访的中位时间为28.5（1 - 261）个月。共有8例患者（5.2%）在中位时间54.5（22 - 219）个月后出现肿瘤复发，且与辛普森分级显著相关（P = 0.004）。共有5例患者发生脑脊液漏，与原发性硬脑膜缝合相比，脑脊液漏与硬脑膜切除及使用补片进行硬脑膜修复无关（P = 0.470）。
包括受影响硬脑膜的全切除可能降低肿瘤复发风险，且在背侧脊髓脑膜瘤中与较高的脑脊液漏发生率无关。仅切除硬脑膜内层是实现辛普森1级切除的有效替代方法。
