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En-bloc resection of thoracic calcified meningioma with inner dural layer in recapping T-saw laminoplasty: a case report.
BMC Surg. 2015 Jul 04; 15:82.BS

Abstract

BACKGROUND

In the treatment of spinal cord tumors, complete tumor resection with complete reconstruction of the spine represents the ideal goal. However, for the treatment of heavily calcified spinal meningioma, en-bloc resection of the tumor together with the involved dura at the tumor base through laminectomy is quite difficult. Conventional laminectomy is not wide enough to allow full exposure of such tumors, and postoperative dural defects can cause serious complications.

CASE PRESENTATION

A 58-year-old Japanese woman presented with a 3-month history of progressive muscle weakness and numbness of the lower extremities. Magnetic resonance imaging (MRI) and computed tomography showed a calcified spinal cord tumor with dural tail sign at the T10-T11 level, severely compressing the spinal cord anterolaterally. The patient underwent en-bloc resection of the tumor with the inner layer of the dura and preservation of the outer layer of the dura through recapping T-saw laminoplasty of T10-T11, including bilateral facet joints. The tumor was histologically diagnosed as meningioma. Postoperatively, the patient achieved complete recovery of neurological functions. Bone union after laminoplasty was obtained within 6 months. Follow-up MRI at 5 years postoperatively demonstrated no recurrence of the tumor.

CONCLUSION

Resection of spinal meningioma with only the inner layer of dura can minimize postoperative complications, including spinal fluid leakage. Recapping T-saw laminoplasty provides extensive exposure for tumor removal. The combination of these techniques may offer an ideal surgical option for complete resection of spinal meningioma with complete preservation of the posterior spinal elements.

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Authors+Show Affiliations

Miyakoshi N
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. miyakosh@doc.med.akita-u.ac.jp.
Hongo M
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Kasukawa Y
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Shimada Y
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.

MeSH

CalcinosisFemaleHumansLaminoplastyMeningiomaMiddle AgedSpinal Cord NeoplasmsThoracic Vertebrae

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26141600

Citation

Miyakoshi, Naohisa, et al. "En-bloc Resection of Thoracic Calcified Meningioma With Inner Dural Layer in Recapping T-saw Laminoplasty: a Case Report." BMC Surgery, vol. 15, 2015, p. 82.
Miyakoshi N, Hongo M, Kasukawa Y, et al. En-bloc resection of thoracic calcified meningioma with inner dural layer in recapping T-saw laminoplasty: a case report. BMC Surg. 2015;15:82.
Miyakoshi, N., Hongo, M., Kasukawa, Y., & Shimada, Y. (2015). En-bloc resection of thoracic calcified meningioma with inner dural layer in recapping T-saw laminoplasty: a case report. BMC Surgery, 15, 82. https://doi.org/10.1186/s12893-015-0066-5
Miyakoshi N, et al. En-bloc Resection of Thoracic Calcified Meningioma With Inner Dural Layer in Recapping T-saw Laminoplasty: a Case Report. BMC Surg. 2015 Jul 4;15:82. PubMed PMID: 26141600.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - En-bloc resection of thoracic calcified meningioma with inner dural layer in recapping T-saw laminoplasty: a case report. AU - Miyakoshi,Naohisa, AU - Hongo,Michio, AU - Kasukawa,Yuji, AU - Shimada,Yoichi, Y1 - 2015/07/04/ PY - 2015/01/21/received PY - 2015/06/16/accepted PY - 2015/7/5/entrez PY - 2015/7/5/pubmed PY - 2015/9/26/medline SP - 82 EP - 82 JF - BMC surgery JO - BMC Surg VL - 15 N2 - BACKGROUND: In the treatment of spinal cord tumors, complete tumor resection with complete reconstruction of the spine represents the ideal goal. However, for the treatment of heavily calcified spinal meningioma, en-bloc resection of the tumor together with the involved dura at the tumor base through laminectomy is quite difficult. Conventional laminectomy is not wide enough to allow full exposure of such tumors, and postoperative dural defects can cause serious complications. CASE PRESENTATION: A 58-year-old Japanese woman presented with a 3-month history of progressive muscle weakness and numbness of the lower extremities. Magnetic resonance imaging (MRI) and computed tomography showed a calcified spinal cord tumor with dural tail sign at the T10-T11 level, severely compressing the spinal cord anterolaterally. The patient underwent en-bloc resection of the tumor with the inner layer of the dura and preservation of the outer layer of the dura through recapping T-saw laminoplasty of T10-T11, including bilateral facet joints. The tumor was histologically diagnosed as meningioma. Postoperatively, the patient achieved complete recovery of neurological functions. Bone union after laminoplasty was obtained within 6 months. Follow-up MRI at 5 years postoperatively demonstrated no recurrence of the tumor. CONCLUSION: Resection of spinal meningioma with only the inner layer of dura can minimize postoperative complications, including spinal fluid leakage. Recapping T-saw laminoplasty provides extensive exposure for tumor removal. The combination of these techniques may offer an ideal surgical option for complete resection of spinal meningioma with complete preservation of the posterior spinal elements. SN - 1471-2482 UR - https://www.unboundmedicine.com/medline/citation/26141600/En_bloc_resection_of_thoracic_calcified_meningioma_with_inner_dural_layer_in_recapping_T_saw_laminoplasty:_a_case_report_ DB - PRIME DP - Unbound Medicine ER -