Foramen magnum meningioma: Surgical planning Analysis with 3d printing

Abstract

Introduction: Foramen magnum meningiomas corresponds about 3 to 3.2% of all meningiomas. And 60 to 77% of all benign extramedullary tumors of the craniocervical junction. Due to its depth, these lesions and the delicate anatomical relationships, their resection demands detailed mastery and control of the complex anatomy of the region.Different approaches for resection of these lesions have been reported:suboccipital,transcondylar, transoral and retrosigmoid craniotomy.Far lateral transcondylar approach have proved to be a safe, wide, sterile surgical access for the exposition of the ventral space to the central nervous system 
that allows good manipulation in a parallel plane. There are specific considerations according to the position and encasement of the vertebral artery, and the extension of the bone resection. With the development of three-dimensional (3D) printing technology, more applications have been used in clinical settings for the planning and performance of surgical procedures, and neurosurgery is not the exception. 3D printed models are created through layer-by-layer deposition by high-precision 3D printers using reconstructed patient CT-scan images. Materials and methods: The clinical case of a patient with a diagnosis of foramen magnum meningioma, pre-surgical planning with a 3D model, surgical resolution, and literature review are presented. Results: Pre-surgical planning is performed on a 3D model, the patient undergoes surgical resolution without complications and she is discharged from the ervice due to improvement. 
Conclusion: The use of current tools allows adequate and precise planning of neurosurgery procedures, as well as extensive explanation and taking individual anatomical considerations to reduce the risk of complications during surgery. 3D models represent a valuable surgical educational tool that improves the understanding of complex lesions of the skull base, for the neurosurgical residents.