Classification, mechanism and surgical treatments for spinal canal cysts

Abstract

A variety of cystic lesions may develop in spinal canal. These cysts can be divided into intramedullary, intradural, extradural, cervical, thoracic, lumbar, and sacral cysts according to anatomical presentation, as well as arachnoid, meningeal, perineural, juxtafacet, discal, neurenteric cysts, and cyst-like lesions according to different etiologies. Mechanisms of initiation and growth vary for different cysts, such as congenital, trauma, bleeding, inflammatory, instability, hydrostatic pressure, osmosis of water, secretion of cyst wall, and one-way-valve effect, etc. Up to now, many treatment methods are available for these different spinal canal cysts. One operation method can be applied in cysts with different types. On the other hand, several operation methods may be utilized in one type of cyst according to the difference of location or style. However, same principle should be obeyed in surgical treatment despite of difference among spinal canal cysts, given open surgery is melely for symptomatic cyst. The surgical approach should be tailored to the individual patient.

Transforaminal endoscopic excision of bi-segmental non-communicating spinal extradural arachnoid cysts: A case report and literature review

“…Various cystic lesions can be found in the spinal canal, including intramedullary, intradural, epidural, perineural, synovial, and intervertebral disc cysts[ 12 ]. As the reliability of MRI has developed, SEACs can now be easily distinguished from other spinal cysts[ 1 , 19 ].…”

“…In 1988, Nabors et al [ 10 ] proposed a classification of arachnoid cysts comprising three categories: SEACs without spinal nerve root fiber involvement (Type I); Type I are further divided into two subtypes, extradural arachnoid cysts (Type Ia) and sacral meningoceles (Type Ib); SEACs with spinal nerve root fiber involvement (Type II); and spinal intradural arachnoid cysts (Type III). Despite multiple efforts to better define these groups, there remains a lack of consensus about how they should be classified[ 11 , 12 ]. SEACs in the spinal canal are usually located on the lateral or posterior side of the dural sac[ 6 , 8 ].…”

An intradural extramedullary bronchogenic cyst in the thoracolumbar spine

“…[ 4 ] Endodermal cysts, which are uncommon lesions, account for 0.5% of spinal cord space-occupying lesions. [ 5 ] There were previous various views on the definition of endodermal cysts; however, Brun and Saldeen defined the characteristics of typical endodermal cysts as follows: has a gastrointestinal and/or respiratory epithelium, and mainly occurs in the cervical and thoracic regions. [ 6 ] Therefore, the term bronchogenic cyst indicates tissues surrounded by the respiratory tract epithelium around endodermal cysts.…”

Percutaneous Endoscopic Lumbar Approach to a Facet Joint Synovial Cyst: Case Report and Review of the Literature

“…The classification of spinal cysts are based in histopathology, localization and etiology. Different types of cyst such as synovial cyst, arachnoid cyst, cyst of the ligamentum flavum, discal cyst and ganglias are present in the spine 1) . The localization can be intradural e extradural and this will determine what type of surgical access will be used.…”

“…The localization can be intradural e extradural and this will determine what type of surgical access will be used. Among the different types of cyst the synovial cyst is the most commonly found 1) .…”