A novel technique for surgical resection of spinal meningioma

Study Design. A technical note. Objectives. To describe and discuss a novel technique for surgical resectio n of spinal meningioma. Summary of Background Data. With conventional methods for surgical resectio n of isolated intradural spinal meningioma, there are two ways of dealing w ith the dural attachment of the tumor. One is complete resection of the inv olved dura together with the tumor, and the other is coagulation only of th e tumor base of the dura. In the case of the novel technique herein describ ed, the dura-mater is preserved in a new manner. Methods. In the surgical procedure a small incision is made in the surface of the dura mater after the conventional laminectomy. The spinal dura can b e easily divided into two layers, comprising inner and outer layers. The ou ter layer is stripped away from the inner layer surrounding the tumor base. The tumor is then resected together with the inner layer alone outside the arachnoid membrane, and finally the outer layer is simply closed. Results. This method has been applied to three cases. The preserved outer l ayer of the dura mater did not demonstrate the existence of tumor cells his tologically. Neither complications nor tumor recurrence have been experienc ed. Conclusion. The authors introduced a novel technique for surgical resection of isolated intradural spinal meningioma. Using this simple procedure the outer part of the dura mater, which is not involved by the tumor, can be pr eserved and complicated dural reconstruction is not necessary. Furthermore, there is less risk of postoperative cerebrospinal fluid fistulas than when the dura is completely resected together with the tumor. However, longterm observation as a result of the possibility of local recurrence is strongly recommended.