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Complication avoidance in the resection of spinal meningiomas
Harrison J Westwick1, Sung-Joo Yuh2, Mohammed F Shamji3
1Division of Neurosurgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montreal, Quebec, Canada.
World Neurosurgery
|December 22, 2014
Summary
Surgical resection of spinal meningiomas is effective but carries risks. Identifying predictive factors and utilizing advanced techniques can minimize postoperative complications and improve patient outcomes.
Area of Science:
- Neurosurgery
- Oncology
- Spinal Surgery
Background:
- Surgical resection is the primary treatment for spinal meningiomas.
- Complications such as neurologic decline can occur postoperatively.
- Understanding risk factors is crucial for improving surgical outcomes.
Purpose of the Study:
- Review factors predicting postoperative neurologic decline in spinal meningioma surgery.
- Discuss therapeutic choices, adjuvant therapies, and technologies to minimize complications.
- Enhance safety and outcomes for patients undergoing spinal meningioma resection.
Main Methods:
- Conducted a literature search for studies on spinal meningiomas.
- Focused on surgical treatment, adjuvant therapies, and technological applications.
- Analyzed data from 16 surgical series including 1090 patients.
Main Results:
- Identified mortality at 1% and permanent neurologic deterioration in 6% of patients.
- Common complications include cerebrospinal fluid leaks, thromboembolic disease, and myocardial infarction.
- Predictive factors for neurologic decline include tumor calcification, dural attachment, infiltrative nature, spinal cord adherence, preoperative deficits, and advanced age.
Conclusions:
- Adjuvant radiotherapy and direct surgical approaches may improve outcomes for high-grade or recurrent meningiomas.
- Advanced technologies like microsurgery, intraoperative monitoring, and ultrasonic aspiration enhance surgical safety.
- Minimizing complications is key to improving patient outcomes after spinal meningioma resection.
