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Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
The management of spinal meningiomas with extensive involvement of the dura mater is controversial. The principal difficulty in performing a resection is the potential for complications associated with this approach. The authors present the case of a pregnant 35-year-old woman in whom bilateral lower-extremity numbness, weakness, gait ataxia, and myelopathy developed. Magnetic resonance imaging showed a recurrent thoracic meningioma with extensive infiltration of the dura mater. Durectomy, complete resection, and reconstruction were performed. The patient has not experienced a recurrence 21 months after her treatment. This case illustrates that thoracic spinal meningiomas with extensive dural involvement can be resected safely with a complete durectomy. The novel dural reconstruction involving the implantation of a fascia lata and bovine pericardium allograft is an effective way to reconstruct the dura to create an adequate barrier to cerebrospinal fluid.
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