Postarachnoiditis Anterior Spinal Arachnoid Cyst Formation with Compressive Myelopathy: Report of 2 Cases

Maenhoudt, Wim; Rasschaert, Ricky; Bontinck, Hugo; Pinson, Harry; Roost, Dirk Van; Hallaert, Giorgio

doi:10.1016/j.wneu.2018.07.006

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…Furthermore, sporadic cases with no remarkable history explaining CSAA have been reported (3.6%) [ 4 , 19 , 20 ]. Historically, infections [ 5 , 18 , [21] , [22] , [23] , [24] ], mostly tuberculous meningitis [ 5 , [25] , [26] , [27] , [28] , [29] ], or myelographies due to the application of an oil-based contrast agent [ 2 , [30] , [31] , [32] , [33] , [34] , [35] ] played a major role as the cause of CSAA. Spinal surgery [ 6 , 11 , 22 , [36] , [37] , [38] , [39] , [40] ] and subarachnoid hemorrhages [ 3 ] continue to play a key role in the development of CSAA.…”

Section: Discussionmentioning

confidence: 99%

Immunotherapies in chronic adhesive arachnoiditis - A case series and literature review

Hackert¹,

Maßmann²,

Sure

et al. 2021

eNeurologicalSci

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Chronic spinal adhesive arachnoiditis (CSAA) is a rare condition with limited therapeutic options. Surgical treatment proves effective in approximately 60% of cases. Conservative treatment options have not been extensively investigated. Here, we report the course of the disease, analyze the effect of immune treatments in patients with CSAA who were treated in the University Hospital Essen between 2015 and 2020, and conduct a literature review. Three out of four patients showed no improvement after treatment with corticosteroids, methotrexate, or plasmapheresis. All non-responders suffered from CSAA for several years, while one patient who had a disease duration of less than one month fully recovered. It is necessary to verify whether treatment at an early stage of the disease is better than treatment after chronic adhesion manifestation, as it interrupts the development of adhesions and all subsequent complications.

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Section: Discussionmentioning

confidence: 99%

Immunotherapies in chronic adhesive arachnoiditis - A case series and literature review

Hackert¹,

Maßmann²,

Sure

et al. 2021

eNeurologicalSci

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“…Los quistes extradurales se desarrollan a partir de protrusiones de la membrana aracnoidea a través de un defecto dural que contienen LCR, y permiten la herniación de la misma; estos tienen un pedículo en el defecto dural que comunica el espacio subaracnoideo espinal con el espacio extradural (5) . Son más frecuentes en hombres durante la segunda década y tienden a ser asintomáticos (1) .…”

Section: Discussionunclassified

Quiste aracnoideo sacro recidivante con meningocele anterior gigante. Reporte de caso

et al. 2019

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“…It is hypothesized that postoperative functional outcomes often depend on multiple factors such as preoperative neurological status, cyst size, and duration of symptoms. 15 Because of these factors, the potential benefits of surgical intervention must be weighed against the possibility of poor surgical outcomes and potential for complications. Interestingly, nearly 40% of patients who were initially managed conservatively ultimately underwent surgical intervention secondary to neurological decline.…”

Section: Treatment and Long-term Neurological Outcomesmentioning

confidence: 99%

Impact of Surgical Timing on Neurological Outcomes for Spinal Arachnoid Cyst: A Single Institution Series

Chatain

Shrestha²,

Kortz³

et al. 2022

Neurospine

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Objective: Spinal arachnoid cysts (SACs) are rare lesions that often present with back pain and myelopathy. There is a paucity of literature evaluating the impact of surgical timing on neurological outcomes for primary SAC management. To compare long-term neurological outcomes in patients who were managed differently and to understand natural progression of SAC.Methods: We conducted a retrospective analysis of adult patients treated for SAC at our institution from 2010 to 2021, stratified into 3 groups (conservative management only, surgical management, or conservative followed by surgical management). Study outcome measures were neurological outcomes as measured by modified McCormick Neurologic Scale (MNS), postoperative complications, and cyst recurrence. Nonparametric analysis was performed to evaluate differences between groups for selected endpoints.Results: Thirty-six patients with SAC were identified. Eighteen patients were managed surgically. The remaining 18 patients were managed conservatively with outpatient serial imaging, 7 of whom (38.9%) ultimately underwent surgical treatment due to neurological decline. Most common presenting symptoms included back pain (50.0%), extremity weakness (36.1%), and numbness/paresthesia (36.1%). Initial/preoperative (p = 0.017) and 1-year postoperative (p = 0.006) MNS were significantly different between the 3 groups, but not at 6 weeks or 6 months postoperatively (p > 0.05). Additionally, at 1 year, there was no difference in MNS between patients managed surgically and those managed conservatively but ultimately underwent surgery (p > 0.99).Conclusion: Delayed surgical intervention in minimally symptomatic patients does not seem to result in worse long-term neurofunctional outcomes. At 1 year, postoperative MNS were significantly higher in both surgical groups, when compared to the conservative group highlighting worsening clinical picture regardless of preoperative observational status.

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Postarachnoiditis Anterior Spinal Arachnoid Cyst Formation with Compressive Myelopathy: Report of 2 Cases

Cited by 10 publications

References 13 publications

Immunotherapies in chronic adhesive arachnoiditis - A case series and literature review

Immunotherapies in chronic adhesive arachnoiditis - A case series and literature review

Quiste aracnoideo sacro recidivante con meningocele anterior gigante. Reporte de caso

Impact of Surgical Timing on Neurological Outcomes for Spinal Arachnoid Cyst: A Single Institution Series

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