Journal article
Exploitation of Simple Classification and Space Created by the Tumor for the Treatment of Foramen Magnum Meningiomas
World neurosurgery, Vol.87, pp.1-7
03/2016
DOI: 10.1016/j.wneu.2015.09.022
PMID: 26409077
Abstract
The resection of foramen magnum meningiomas (FMMs) presents neurosurgical challenges. We propose a simple classification of the tumor location and the operating space created by the tumor to help treatment planning.
We retrospectively analyzed 16 FMMs and divided them into 3 groups based on the tumor location—clival, foraminal, and atlantal tumors. The distance between the condyle and the neuraxis at the level of the foramen magnum was measured and defined as the available operative space (AOS). We also reviewed intraoperative video recordings to assess the surgical exposure of the tumor by the space created by the FMM and compared it with the AOS.
There were 4 clival, 8 foraminal, and 4 atlantal tumors. The AOS of the clival tumors was 10 mm ± 1.7, the AOS of the foraminal tumors was 18 mm ± 3.7, and the AOS of the atlantal tumors was 12 mm ± 2.1. All foraminal and atlantal tumors could be detached without a brain retractor. Because a major portion of the clival tumors was covered by the spinomedullary junction, a brain spatula was needed to obtain the required surgical space. The difference in AOS between clival and foraminal/atlantal tumors was statistically significant (P = 0.044). Although 4 patients experienced postoperative complications, the average postoperative Karnofsky performance scale score improved. The surgical complication rate was significantly lower in foraminal and atlantal FMMs than in clival FMMs (P = 0.027).
The simple classification of the tumor location helped to assess surgical difficulties. Knowledge of the space created by the FMMs between the condyle and the neuraxis is useful for planning the approach strategy, especially for estimating the available working space without resection of the occipital condyle.
Details
- Title: Subtitle
- Exploitation of Simple Classification and Space Created by the Tumor for the Treatment of Foramen Magnum Meningiomas
- Creators
- Hitoshi Yamahata - Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, JapanSatoshi Yamaguchi - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, JapanMasakazu Takayasu - Department of Neurosurgery, Aichi Medical University, Nagakucte, Aichi, JapanKoji Takasaki - Department of Neurosurgery, Atsuchi Neurosurgical Hospital, Kagoshima, JapanKoji Osuka - Department of Neurosurgery, Aichi Medical University, Nagakucte, Aichi, JapanMasahiro Aoyama - Department of Neurosurgery, Aichi Medical University, Nagakucte, Aichi, JapanMuneyoshi Yasuda - Department of Neurosurgery, Aichi Medical University, Nagakucte, Aichi, JapanHiroshi Tokimura - Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, JapanKaoru Kurisu - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, JapanKazunori Arita - Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
- Resource Type
- Journal article
- Publication Details
- World neurosurgery, Vol.87, pp.1-7
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.wneu.2015.09.022
- PMID
- 26409077
- ISSN
- 1878-8750
- eISSN
- 1878-8769
- Language
- English
- Date published
- 03/2016
- Academic Unit
- Neurosurgery
- Record Identifier
- 9984040397802771
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