1-2009

.: Дата публікації 2009-04-03 :: Переглядів: 11 :: :.

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Peculiarities of the surgical techniques for spinal meningiomas
E.I. SLYN’KO, O.I. TROYAN, E.S. YARMOLYUK

Purpose: to improve the results of the surgical treatment for spinal meningiomas (SM) due to the application of optimal operative approaches and the use of microsurgical technique.

Methods and subjects. 46 patients with SM have been operated at the A.P. Romodanov Institute of Neurosurgery over the period from 2005 to 2008. The age of the patients in average was 54 ± 7 years. In 11 (24 %) patients SM were found in the cervical spine, 29 (63 %) and 6 (33 %) – in the thoracic and lumbar spine respectively. 12 (26 %) patients had dorsal SM, 16 (34 %) – dorso_lateral, 10 (21.7 %) – ventro_lateral, 3 (5 %) – lateral, 5 (10.7 %) – ventral meningiomas. In 36 (72 %) cases tumors demonstrated a capsule, in 4 (8.7 %) – infiltrative growth, calcificated tumors were found in 6 (13.1 %). 32 patients suffered from radicular pain, motor weakness and sensory abnormalities were diagnosed in 44 patients, 18 patients had impaired sphincter functions. 30 (65.2 %) patients underwent laminесtomy, 8 (17.4 %) –

hemilaminоесtomy, 4 (8.7 %) – laminесtomy and fasetectomy. Ventral and ventro-lateral calcificated and en plaque SM (4 (8.7 %)) in the cervical spine required anterior approach.

Results. At the moment of discharge 39 (84.7 %) patients demonstrated good postoperative status, 5 (11 %) showed satisfactory and 2 (4.3 %) – unsatisfactory results.

Conclusions. A proper diferentiative operative approach and the use of microsurgical techniques for spinal meningiomas allows the total tumor’s removal, restoration of neurological functions and prevents unfavorable outcomes.