Inner dual layer resection in the treatment of spinal meningiomas

Abstract

Objective To describe and discuss Saito technique for surgical resection of spinal meningiomas. Method In the surgical procedure of a small incision was made in the surface of the dura mater after the conventional laminectomy. The spinal dura could be easily divided into two layers, comprising inner and outer layers. The outer layer was stripped away from the inner layer surrounding the tumor base. The tumor was then resected together with the inner layer alone outside the arachnoid membrane, and finally the outer layer was simply closed. ResultsSaito technique has been applied to thirty - six cases. Neither complications nor tumor recurrence have been experienced followed up for a mean time 31 months ( range 12 -72 months). The preserved outer layer of the dura mater did not demonstrate the existence of tumor cells histologically. Conclusions The authors introduced Saito technique for surgical resection of isolated intradural spinal meningioma. Using Saito procedure the outer part of the dura mater, which is not involved by the tumor,can be preserved and complicated dural reconstruction is not necessary. Furthermore, there is less risk of postoperative cerebrospinal fluid fistulas than when the dura is completely resected together with the tumor. However, long term observation as a result of the possibility of local recurrence is strongly recommended. Key words: Spinal meningioma; Saito technique; Spinal dural preservation; Surgical procedures, operative