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Intradural spinal meningomas - institutional experience
Author(s): ,
V. Priban
Affiliations:
University hospital Pilsen, of Neurosurgery, Pilsen, Czech Republic
,
D. Bludovsky
Affiliations:
Charles University, of Neurosurgery, Pilsen, Czech Republic
,
M. Choc
Affiliations:
University hospital Pilsen, pf Neurosurgery, Pilsen, Czech Republic
I. Holeckova
Affiliations:
University hospital Pilsen, Pilsen, Czech Republic
EANS Academy. Priban V. Oct 21, 2018; 225798; EP2153
Assoc. Prof. Vladimir Priban
Assoc. Prof. Vladimir Priban
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Introduction: Spinal meningiomas represent relatively rare entity in comparison with intracranial ones. First surgery was done by Victor Horsley in 1887 with satisfactory result. Women are predominantly affected and location in thoracic spine is in nearly 80 percent of patients.
Material and methodics: In the period 2000-2017 were operated on 62 patients in our institution. There were 47 women (75%) and 15 men (25%). Mean age was 64,4 year (31-88). Location of tumor was in 6 patients in C spine, in 7 patient in C-Th spine, in two patients in lumbar spine and predominantly in 47 patients in Th spine (75%). Symptoms were spastic paraparesis in 42 patients, modified Brown-Sequard syndrom in 15 patient, radicular symptom in 4 patients and one patient was asymptomatic. Surgical procedure: laminectomy in 57 patients, laminectomy + fixation in 1 patient, in 2 patients and laminoplasty in 2 patients. Nurick scoring system has been used for evaluation of outcome. Intraoperative electrophysiological monitoring is used in last 10 years in all cases.
Results: Preoperative mean Nurick score was 3.21 and postoperative 1.85. Preoperative score Nurick grade 0-3 (self-sufficiency) was in 35 patients (56%) and postoperative in 52 patients (84%). Nurick grade 4-5 was preoperatively in 27 patients (44%) and postoperatively in 10 patients (16%). 54 patients improved after surgery, 8 patients remained stable a no patient worsened.
Conclusion: Surgery for spinal intradural meningiomas represents optimistic field in neurosurgery. Most patients profit from this procedure regardless of preoperative neurological deficit. Microsurgical technique together with intraoperative electorphysiology must be always used.
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