Durectomy and reconstruction for the treatment of a recurrent spinal meningioma. Case report.
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.
Horn
Eric M
EM
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
Deshmukh
Vivek R
VR
Lekovic
Gregory P
GP
Dickman
Curtis A
CA
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