Resection of spinal meningioma using ultrasonic bonescalpel microshaver: Cases, technique, and review of the literature

Saeed Sam Sadrameli, Tiffany Michelle Chan, Jonathan Jinhee Lee, Virendra R. Desai, Paul J. Holman

Research output: Contribution to journalReview articlepeer-review

Abstract

BACKGROUND: Meningiomas of the spinal canal comprise up to 40% of all spinal tumors. The standard management of these tumors is gross total resection. The outcome and extent of resection depends on location, size, patient’s neurologic status, and experience of the surgeon. Heavily calcified spinal meningiomas often pose a challenge for achieving gross total resection without cord injury. OBJECTIVE: To report our experience with the BoneScalpel Micro-shaver to resect heavily calcified areas of spinal meningiomas adherent to the spinal cord without significant cord manipulation, achieving gross total resection and outstanding clinical results. METHODS: Seventy-nine and 82-yr-old females presented with progressive leg weakness, paresthesias, and gait instability. Magnetic resonance imaging of the thoracic spine showed a homogenous enhancing intradural extramedullary mass with mass effect on the spinal cord. Midline bilateral laminectomy was performed, and the dura was open in midline. The lateral portion of the tumor away from the spinal cord was resected with Cavitron Ultrasonic Surgical Aspirator while the BoneScalpel Micro-shaver (power level 5 and 30% irrigation) was brought into the field for the calcified portion of the tumor adherent to the spinal cord. RESULTS: Gross total resection was achieved for both cases. At the 2-wk postoperative visit, both patients reported complete recovery of their leg weakness with significant improvement in paresthesias and ataxia. CONCLUSION: The ultrasonic osteotome equipped with a microhook tip appears to be a safe surgical instrument allowing for effective resection of spinal meningiomas or other heavily calcified spinal masses not easily removed by usual surgical instrumentation.

Original languageEnglish (US)
Pages (from-to)715-720
Number of pages6
JournalOperative Neurosurgery
Volume19
Issue number6
Early online dateJul 29 2020
DOIs
StatePublished - Dec 1 2020

Keywords

  • Calcified meningioma
  • Minimally invasive surgery
  • Spinal cord
  • Spinal meningioma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Resection of spinal meningioma using ultrasonic bonescalpel microshaver: Cases, technique, and review of the literature'. Together they form a unique fingerprint.

Cite this