2カ所に発生した脊髄髄膜腫に対して斉藤らの硬膜処理法により全摘出しえた1例

Surgical Resection of Spinal Meningiomas in Two Separate Regions of the Spinal Cord Using Saito's Technique. Case Report

　髄膜腫の手術的治療では従来，腫瘍を硬膜ごと一塊として摘出する方法が一般的である．この術式では硬膜欠損が生ずるため，同部に人工硬膜を縫着し髄液漏が発生するリスクがあった．斉藤らは，2001年硬膜内髄外の脊髄髄膜腫でその硬膜付着部が脊髄の背側または背外側に存在するものに対して，硬膜外層を温存する新しい硬膜処理法による摘出術を報告した．今回2カ所に発生した髄膜腫に対して同様の術式を用いて全摘出し，人工硬膜縫着の必要性や髄液漏を生ずることなく治療しえたので，若干の文献的考察を加え報告する．

　Spinal meningiomas have generally been resected with the dura mater.　However, because such operations result in a dural defect and cerebrospinal fluid leakage, the defect must be repaired with artificial dura.　In 2001 Dr. Saito reported a novel technique for surgical resection of spinal meningiomas that preserves the outer layer of the dura and is indicated for intradural and extramedullary spinal meningiomas that are located in the dorsal or dorsolateral area.　We encountered a patient with spinal meningiomas that simultaneously developed at the T1 level and T10 level, and we completely resected them both by Dr. Saito's novel technique without artificial dura repair or cerebrospinal fluid leakage.　We report this case of surgical resection of spinal meningiomas in two separate regions of the spinal cord together.