title: Durectomy and reconstruction for the treatment of a recurrent spinal meningioma. Case report.
abstract: The management of spinal meningiomas with extensive involvement of the dura mater is controversial. The principal difficulty in performing a resection is the potential for complications associated with this approach. The authors present the case of a pregnant 35-year-old woman in whom bilateral lower-extremity numbness, weakness, gait ataxia, and myelopathy developed. Magnetic resonance imaging showed a recurrent thoracic meningioma with extensive infiltration of the dura mater. Durectomy, complete resection, and reconstruction were performed. The patient has not experienced a recurrence 21 months after her treatment. This case illustrates that thoracic spinal meningiomas with extensive dural involvement can be resected safely with a complete durectomy. The novel dural reconstruction involving the implantation of a fascia lata and bovine pericardium allograft is an effective way to reconstruct the dura to create an adequate barrier to cerebrospinal fluid.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Horn
authors.forename: Vivek R
authors.initials: VR
authors.lastname: Deshmukh
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Lekovic
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Dickman
mesh_terms: D000328:Adult; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D013904:Thoracic Vertebrae