Simpson grade 3 resection does not improve clinical outcome in neglected thoracic psammomatous spinal meningioma? A case report

International Journal of Surgery Case Reports
Azharuddin AzharuddinReno Keumalazia Kamarlis

Abstract

Thoracic spinal psammomatous meningioma is a rare subtype of meningioma. Surgery is the definitive treatment for symptomatic spinal meningiomas and offers a substantial possibility for complete resection and cure. A 42-year-old female complaining of back pain for one year and progressive weakness and numbness of both lower limbs with urinary incontinence and constipation for two months. Magnetic resonance imaging showed an intramedullary spinal mass at D3-D4 level. The patient underwent laminectomy at D3-D5 level, revealing dural bulge. A midline durotomy performed. Intraoperative findings showed firmed, greyish to white and moderately vascular mass. A clear margin was identifiable between cord and tumor. Simpson grade 3 resection was performed. Pedicle screw and rod was placed for posterior stabilization. Histopathological examination demonstrated a psammomatous spinal meningioma. Despite the pain and the sensory sensation was improved, the motoric and autonomic function still showed no significant improvement in the early postoperative period. The preferred approach or procedure must be tailored case by case based on preoperative surgical grading of the tumor and its associated factors. Meanwhile, the prognosis for recovery d...Continue Reading

References

Sep 21, 2013·The Spine Journal : Official Journal of the North American Spine Society·Silky P ChotaiAzedine Medhkour
Sep 23, 2014·Case Reports in Surgery·Atef Ben NsirNejib Hattab
Oct 28, 2014·Korean Journal of Spine·Seong Kyun JeongSung Woo Roh
Sep 1, 2012·Korean Journal of Spine·Hoi Jung ChoiYong Tae Jung
May 10, 2017·Asian Journal of Neurosurgery·Akhil PrakashSandeep Kansal
Oct 21, 2018·International Journal of Surgery·Riaz A AghaUNKNOWN SCARE Group

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surgical resection
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