Safety and efficacy of posterior approach for resection of spinal meningioma: Impact of dural attachment location

doi:10.12998/wjcc.v12.i36.6905

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World Journal of Clinical Cases

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Retrospective Study

World J Clin Cases. Dec 26, 2024; 12(36): 6905-6915
Published online Dec 26, 2024. doi: 10.12998/wjcc.v12.i36.6905

Safety and efficacy of posterior approach for resection of spinal meningioma: Impact of dural attachment location

Hong Chen, Ya-Ni Fu, Chu-Di Fu

Hong Chen, Ya-Ni Fu, Chu-Di Fu, Department of Orthopedics, The 903rd Hospital of Joint Logistic Support Force of People’s Liberation Army, Hangzhou 310000, Zhejiang Province, China

Author contributions: Chen H provided the idea, designed the study and wrote the manuscript; Fu YN collected and analyzed the data, and prepared the tables and figures; Fu CD revised the manuscript and supervised the study. All authors have read and approved the final manuscript.

Institutional review board statement: The study was reviewed and approved by No. 903 Hospital of PLA Joint Logistic Support Force.

Informed consent statement: The studies involving humans were approved by the Ethics Committee of 903 Hospital and conducted in accordance with local legislation and institutional requirements. Signed consent was waived because the study was a retrospective review of medical records and involved the preservation of anonymity during data collection, statistical analysis and manuscript writing.

Conflict-of-interest statement: The authors declare that the study was conducted in the absence of any commercial or financial relationships, and there is no conflict of interest.

Data sharing statement: All data can be obtained from the first author.

Corresponding author: Chu-Di Fu, MD, Director, Professor, Surgeon, Department of Orthopedics, The 903rd Hospital of Joint Logistic Support Force of People’s Liberation Army, No. 40 Jichang Road, Shangcheng District, Hangzhou 310000, Zhejiang Province, China. nzglfcd@163.com

Received: April 16, 2024
Revised: September 29, 2024
Accepted: October 15, 2024
Published online: December 26, 2024
Processing time: 197 Days and 13.8 Hours

Abstract

BACKGROUND

Spinal meningiomas (SMs) are common benign tumors that are typically treated with surgical resection. The choice of surgical approach may vary depending on the location of dural attachment of the SM, with a posterior approach being the traditional preference. However, there is limited research available on the impact of dural attachment location on outcomes following posterior approach for SM resection.

AIM

To investigate the outcomes of posterior approach for SM resection, and compare the results among different dural attachment location subgroups.

METHODS

Between January 2013 and February 2023, a total of 34 SM patients were included in the study. Various clinical and radiologic features, functional states before and after surgery, operating time, intraoperative blood loss, tumor recurrence, and perioperative complications were assessed and compared.

RESULTS

The average age of the included 34 patients’ (10 males and 24 females) age was 62.09 years. Mean follow-up duration was 22.65 months. The location of SM was the thoracic spine in 32 cases, with only 2 in the cervical spine. On average, intraoperative blood loss was 520.59 mL, and operating time was 176.76 minutes. Thirty three cases had successful outcomes while only 1 experienced an unexpected outcome. The tumor recurrence rate was 2.9%. After surgery, there were 3 cases of cerebral spinal fluid leakage, 1 case of pneumonia, and 1 case of urinary tract infection. Dural attachments were predominantly found dorsal or dorsolateral (13 cases), followed by ventral or ventrolateral (14 cases), and lateral (7 cases). The outcomes among these subgroups were similar.

CONCLUSION

The posterior approach for SM resection is safe and effective, yielding comparable surgical and neurological outcomes regardless of the dural attachment location.

Keywords: Spinal meningioma; Posterior approach; Dural attachment; Outcomes; Complications; Recurrence

Core Tip: This retrospective study aimed to assess the safety and efficacy of the posterior approach for spinal meningiomas resection, and compare the outcomes among different dural attachment location subgroups. Thirty four patients with an average follow-up time of 22.65 months were included. The average operating time was 176.76 min, with intraoperative blood loss of 520.59 mL. Satisfactory outcomes were observed in 97.06% of cases and the tumor recurrence rate was 2.94%. There were no significant differences in operating time, intraoperative blood loss, neurological function, and recurrence rates among three distinct dural attachment location subgroups.