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Case Reports
. 2023 Oct 30;4(4):e00063.
doi: 10.1227/neuprac.0000000000000063. eCollection 2023 Dec.

Removal of Spinal Calcified Meningiomas With Piezosurgery: Technical Note on a New Application of a Known Device

Rossella Rispoli  1 , Stefano Pizzolitto  2 , Barbara Cappelletto  1
Affiliations
Case Reports

Removal of Spinal Calcified Meningiomas With Piezosurgery: Technical Note on a New Application of a Known Device

Rossella Rispoli et al. Neurosurg Pract. .

Abstract

Background and importance: Ossified spinal meningiomas are a rare form of spinal tumor. The removal in narrow surgical space is challenging because of their hard consistency and strong adhesion to the neural tissue. These meningiomas are often located in the upper thoracic spine, and sometimes, even the identification of the correct intraoperative level is difficult.

Clinical presentation: We describe the clinical findings, surgical strategies, and histological findings of a patient with a thoracic ossified meningioma.

Discussion: We discuss the technical points, safety, and efficacy of the piezosurgery device in reducing the calcified mass.

Conclusion: The device has the potential to reduce the operating time and enhance surgical safety when removing ossified meningiomas.

Keywords: Case report; Ossified meningioma; Piezosurgery; Thoracic spine.

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Conflict of interest statement

The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

Figures

FIGURE 1.
FIGURE 1.
A, Antero-posterior thoracic spine x-rays and B, coronal T2-weighted MRI showing proximal thoracic right convex scoliosis and right T5 hemivertebra.
FIGURE 2.
FIGURE 2.
Left side sagittal slice of the whole spine T2-weighted MRI showing the neoplasm at the T4-T6 level in this patient with a T5 right hemivertebra.
FIGURE 3.
FIGURE 3.
The neoplasm was hypointense on A, T1-weighted and B, T2-weighted images and peripherally enhanced with gadolinium on C, a sagittal and D, axial T1-weighted image.
FIGURE 4.
FIGURE 4.
Cervico-thoracic computed tomography scan, using bone algorithm, showing the intradural round calcified mass occupying almost the entire spinal canal on A, the sagittal and B, axial plane.
FIGURE 5.
FIGURE 5.
MF3 insert with a diamond-coated ball tip.
FIGURE 6.
FIGURE 6.
Hematoxylin-eosin staining histopathology showing A, a fibroblastic meningioma with extensive mesenchymal osseous component, 100×; B, fibrous and psammoma bodies with adjacent trabecular ossification and vascular islands, 100×; C, fibrous component with psammoma bodies at higher magnification, 400×; D, epithelial membrane antigen immunoreactivity reveals meningothelial cells between psammoma bodies, 400×.
FIGURE 7.
FIGURE 7.
A, Sagittal and B, axial postoperative T2-weighted MRI showing complete tumor removal.
See this image and copyright information in PMC

References

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