Surgical management of intradural extramedullary tumors located anteriorly to the spinal cord.
Meningiomas and nerve sheath tumors are the most common lesions found in the intradural extramedullary compartment of the spine. Some of these lesions can be located anteriorly to the spinal cord, constituting a challenge for spine surgeons. We present a surgical technique that improves the surgical exposure of lesions located anteriorly or antero-laterally to the spinal cord. A microsurgical technique of tenting of the dentate ligament with sutures and rotation of the spinal cord is described in detail and illustrated with surgical cases. This technique increases the small microsurgical operative field and allows spinal cord retraction with the use of a natural cord component, minimizing pressure on the spinal cord delicate tissue, allowing total tumor resection. In conclusion, total resection without new neurological deficit of anterior and antero-lateral tumors can be performed using an isolated posterior approach with rotation of the spinal cord using tenting of the dentate ligament with sutures.
Neurosurgery Division, State University of Campinas (UNICAMP), Rua Antônio Lapa, 280, Edifício América Cambuí, bairro Cambuí, 5° andar, Campinas, SP CEP 13025-240, Brazil.
Andrei Fernandes
AF
Joaquim
João Paulo
JP
Almeida
Marcos Juliano
MJ
Dos Santos
Enrico
E
Ghizoni
Evandro
E
de Oliveira
Helder
H
Tedeschi
D000328:Adult; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D013116:Spinal Cord / Q000601:surgery*; D055815:Young Adult