Intrathoracic dural ectasia mimicking neurofibroma and scoliosis

Helfen, M.; Götzinger, R.; Lütke, A.; Likoyiannis, A.; Griss, P.

doi:10.1007/bf00181866

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…To the best of our knowledge, only seven patients with similar dural cysts have been reported in the literature, and these are summarized in Table 1. 1,2,5,8,10 A similar dural cyst of the cerebellum has been reported in a 9-month-old boy. 7 Whereas the intracranial dura mater can be separated into two distinct layers with a potential epidural space, the spinal dura represents a downward extension of the inner layer of the cerebral dura.…”

Section: Discussionsupporting

confidence: 58%

Dural cysts in the cervical region

Hamburger¹,

Büttner²,

Weis³

1998

Journal of Neurosurgery

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Dural spinal cysts are exceedingly rare lesions. The authors are aware of only seven cases reported in the literature. This report comprises three patients with dural cysts of the cervical spinal canal who presented with atypical neurological signs and symptoms, including a long history of dysesthesias and atrophic pareses in the proximal upper extremities. Surgical intervention disclosed two ventrally and one dorsally located cystic lesions of the spinal dura mater. The cystic wall was fenestrated and kept open by a silicone catheter in each case. Histological examination of the excised lesions revealed fibrous connective tissue consistent with dural tissue. No epithelial lining was detected. The lesions were classified as dural cysts. The patients' postoperative courses were uneventful. Although dural cysts are rare lesions, they must be considered in the differential diagnosis of spinal cystic lesions. Because they are nonaggressive and can be safely drained by microsurgical techniques, patients have a favorable prognosis. Early surgical intervention is mandatory to prevent severe neurological deficits.

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Section: Discussionsupporting

confidence: 58%

Dural cysts in the cervical region

Hamburger¹,

Büttner²,

Weis³

1998

Journal of Neurosurgery

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“…Successful posterior fusion with little progression of dural ectasia and spinal deformities, as observed in our case, has been reported [9]. The progression of dural ectasia and bone erosion despite surgical treatment has also been documented [6].…”

Section: Discussionsupporting

confidence: 52%

“…Earlier studies have reported various treatments for spinal deformities in the thoracic or lumbar spine [6][7][8][9][10][11][12][13], but reports pertaining to cervical spine deformities have been rare [14,15]. Furthermore, few studies have assessed the long-term follow-up findings of dural ectasia postoperatively.…”

Section: Introductionmentioning

confidence: 96%

Eight-year follow-up findings of surgical treatment for severe dystrophic changes in the cervical spine associated with neurofibromatosis type I: a case report

Kita

Yamashita²,

Abe³

et al. 2017

Journal of Pediatric Orthopaedics B

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Long-term follow-up findings for dystrophic changes in the cervical spine caused by neurofibromatosis type 1 have been rarely reported. A 13-year-old boy with severe dural ectasia in the cervical spine underwent cervical posterior fusion from C1 to C5 for prevention of cervical spine fracture and spinal injury. We followed him up for 8 years after surgery. We measured the progression of the destruction on yearly MRI. The dural ectasia gradually progressed until 3 years postoperatively. Subsequently, no further enlargement of the dural sac occurred. At the 8-year follow-up examination, the patient had no limitations in the activities of daily life.

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“…[ 21 35 ] On the other hand, dural ectasia has been reported after trauma and after spinal surgery[ 21 36 ] as well. In additional, the pathology can also occur at cervical[ 37 ] or thoracic levels[ 38 ] without lumbar involvement. Curiously, our patient had no history of connective tissue disorder, and no signs/symptoms to suggest an undiagnosed disorder.…”

Section: Discussionmentioning

confidence: 99%

Marsupialization and distal obliteration of a lumbosacral dural ectasia in a nonsyndromic, adult patient

Nguyen

Lozen

Doan

et al. 2015

J Craniovert Jun Spine

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Dural ectasia is frequently associated with connective tissue disorders or inflammatory conditions. Presentation in a patient without known risk factors is rare. Moreover, the literature regarding the treatment options for symptomatic dural ectasia is controversial, variable, and limited. A 62-year-old female presents with intractable, postural headaches for years. A lumbar puncture revealed opening pressure 3 cm of water. A computed tomography myelogram of the spine demonstrated erosion of her sacrum due to a large lumbosacral dural ectasia. An initial surgery was attempted to reduce the size of the expansile dura, and reconstruct the dorsal sacrum with a titanium plate (Depuy Synthes, Westchester, PA, USA) to prevent recurrence of thecal sac dilatation. Her symptoms initially improved, but shortly thereafter recurred. A second surgery was then undertaken to obliterate the thecal sac distal to the S2 nerve roots. This could not be accomplished through simple ligation of the thecal sac circumferentially as the ventral dura was noted to be incompetent and attempts to develop an extradural tissue plane were unsuccessful. Consequently, an abundance of fibrin glue was injected into the thecal sac distal to S2, and the dural ectasia was marsupialized rostrally, effectively obliterating the distal thecal sac while further reducing the size of the expansile dura. This approach significantly improved her symptoms at 5 months follow-up. Treatment of dural ectasia is not well-defined and has been variable based on the underlying manifestations. We report a rare patient without risk factors who presented with significant lumbosacral dural ectasia. Moreover, we present a novel method to treat postural headaches secondary to dural ectasia, where the thecal sac is obliterated distal to the S2 nerve roots using an abundance of fibrin glue followed by marsupialization of the thecal sac rostally. This method may offer an effective therapy option as it serves to limit the expansile dura, reducing the cerebrospinal fluid sump and the potential for intracranial hypotension.

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Intrathoracic dural ectasia mimicking neurofibroma and scoliosis

Cited by 7 publications

References 23 publications

Dural cysts in the cervical region

Dural cysts in the cervical region

Eight-year follow-up findings of surgical treatment for severe dystrophic changes in the cervical spine associated with neurofibromatosis type I: a case report

Marsupialization and distal obliteration of a lumbosacral dural ectasia in a nonsyndromic, adult patient

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