Microscopic Keyhole Technique for Surgical Removal of Thoracic Spinal Meningiomas

The aim of this study was to evaluate the safety and efficacy of the microscopic minimally invasive keyhole technique for surgical resection of thoracic spinal meningiomas.

Seventeen consecutive patients with thoracic spinal meningiomas were included in the series from May 2015 to August 2017. All patients were treated using a microscopic keyhole technique through a tubular retractor system. The demographic data and perioperative variables were recorded. At last follow-up, clinical outcome was assessed using the visual analog scale for pain and the American Spinal Injury Association scale for motor and sensory outcome.

All patients underwent microscopic keyhole surgery and complete resection was achieved. Mean operative time was 153.2 minutes (range 115-300 minutes). Mean blood loss during surgery was 110.3 mL (range 50-175 mL). No infection or aggravation of spinal cord injury occurred after operation, except for 2 patients who had postoperative cerebrospinal fluid leakage that recovered after conservative treatment. The mean duration of hospital stay was 6.8 days (range 5-10 days). At the last follow-up, all patients had a reduced level of pain as suggested by an average visual analog scale score that improved from 7.6 to 0.2. The American Spinal Injury Association grade improved or remained normal in all patients except 1. No evidence of tumor recurrence or secondary spinal deformity was observed in any patients during the postoperative follow-up period, and spinal stabilities were found to be satisfactory.

Based on our results, the microscopic minimally invasive keyhole technique can be used safely and effectively for resection of thoracic spinal meningiomas.