Spinal extradural arachnoid cysts: clinical, radiological, and surgical features

Liu, James K.; Cole, Chad; Kan, Peter; Schmidt, Meic H.

doi:10.3171/foc.2007.22.2.6

Cited by 106 publications

(164 citation statements)

References 25 publications

(41 reference statements)

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“…The dural sleeve of the nerve or the junction of the sleeve and thecal sac are the most common sites. 5,7) The theory of a congenital origin, such as congenital neural tube defect or congenital diverticulum of the dura mater, is supported by two reports. 5,7) Meanwhile, several theories of acquired origin, such as following spinal surgery, trauma, chronic arachnoiditis, parasitic infection, or degenerative changes of spondylosis, have also been reported.…”

Section: Discussionmentioning

confidence: 51%

Thoracolumbar Extradural Arachnoid Cyst

Tomii

Mizuno

Takeda

et al. 2013

Neurol. Med. Chir.(Tokyo)

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Three cases of symptomatic extradural arachnoid cyst were treated by surgery. Total excision of the cyst followed by tight closure of the fistula by suture was achieved in all 3 cases. Surgery improved the neurological deficits but urinary incontinence persisted in all three patients. Obliteration of the fistula is considered to be important at surgery from the etiological perspective of the cyst. There are many surgical options, but surgical removal of the cyst and obliteration of the communication usually leads to prompt improvement in neurological deficits. Instability, malalignment, and worsening scoliosis are well-recognized postoperative complications of excessive laminotomy, but the exposure should be wide enough to cover the cyst completely at the operation. Wide exposure of the entire cyst is preferable to avoid missing the fistula and to identify any adhesions or fistula between the cyst and the dura. Identification of the fistula location based on preoperative imaging studies is also important.

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Section: Discussionmentioning

confidence: 51%

Thoracolumbar Extradural Arachnoid Cyst

Tomii

Mizuno

Takeda

et al. 2013

Neurol. Med. Chir.(Tokyo)

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“…This mechanism then may allow further enlargement, with persistent CSF pulsations. 4,5) The presence or absence of a check-valve mechanism is very important in determining the need for surgical intervention for sacral meningeal cysts.…”

Section: Discussionmentioning

confidence: 99%

A rare cause of thoracic spinal cord compression by multiple large Tarlov cysts

et al. 2018

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IntroductionThe spinal extradural arachnoid cyst (SEAC) is a rare cause of spinal cord compression. The etiology of SEAC remains unclear. They appear to be extradural outpouchings of arachnoid membranes that communicate with the intraspinal subarachnoid space through small defect in the dura. 7,10,17) Tarlov cyst (TC) are predominantly found at the lumbosacral level of the spine but they are known to exist at all levels of the spine. Bifocal location of SEACs, thoracic and sacral, is exceedingly rarely reported in the literature. Here in we report a case of thoracic spinal cord compression by SEAC associated with asymptomatic multiple sacral cysts. The surgical management and postoperative outcome are discussed. Case ReportA 34-year-old woman with no history of trauma was referred to the emergency department for acute thoracic pain superimposed on a background of chronic long-standing back pain. The patient was complaining of walking difficulties. Neurological examination demonstrated an incomplete spastic paraplegia, grade 2 motor power in both lower limbs, with sensory level in T9, with pyramidal syndrome in the inferior limbs bilateral plantar extension responses, with hyperreflexia of both Achilles tendons reflexes were present. Sensory, bladder, and bowel functions were unremarkable. Imaging a spinal magnetic resonance imaging Spinal extradural arachnoid cyst (SEAC) is a rare cause of spinal cord compression. Bifocal location of thoracic and sacral SEACs is rarely reported in the literature. We report a case of thoracic spinal cord compression by SEAC associated with asymptomatic multiple sacral Tarlov cysts (TC). The surgical management and postoperative outcome of the patient are discussed. A 34-year-old woman was referred to the hospital for acute thoracic pain with a history of chronic long-standing back pain. She complained of walking difficulties. Neurological examination demonstrated incomplete spastic paraplegia with sensory level in T9. Magnetic resonance imaging revealed a large cystic formation from T7 11 and at the level of the sacrum. We performed laminectomies at the level of interest from T7 11. The cysts were dissected from the underlying dura after removal of the cerebrospinal fluid. We found nerve tissue in the cysts. We excised the cyst and preserved the nerve roots. Subsequently, a duraplasty was performed with autologous grafts from the lumbar fascia. The condition of the patient improved after surgery and he was recovering well at follow-up. Although the surgical treatment of TC is controversial, especially at the sacral lumbar level, decompression at the dorsal level in this case is indisputable. KEY WORDS Extradural arachnoid cyst ㆍSpinal cord compression ㆍTarlov cyst.

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“…Alternative treatment options such as shunting procedures (11) have their inherent risks and are less favorable (12). Several less invasive techniques have been proposed recently (13) but single aspiration is not recommended because cysts tend to refill (3,14).…”

Section: Discussionmentioning

confidence: 99%

“…It was considered that the etiology of EMCs is commonly congenital and rarely acquired due to inflammatory, iatrogenic and traumatic reasons (1,4) but it was not always possible to identify the etiology precisely. The therapeutic guidelines are not also well-established yet, but generally surgical interventions in the presence of neurological deficit, and otherwise conservative approaches were advised (1)(2)(3). However, the management of the huge EMCs which cause some neurological symptoms but not significant deficits were a problematic subject for the physicians.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spinal Ekstradural Meningeal Kist: Hatalı Radyografik ve Klinik Tanı

Özşahin¹,

Durmuş²,

Çakar³

et al. 2012

tftr

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Sum maryExtradural meningeal cysts are rare lesions and are uncommon causes of spinal cord or nerve compression. Most of these lesions probably remain unrecognized life-long, because they cause no symptoms. With the widespread use of new imaging techniques, asymptomatic spinal extradural meningeal cysts are becoming increasingly common. The therapeutic guidelines have not been well-established yet. Generally, patients with neurological deficits undergo surgery, whereas conservative approach is advised in asymptomatic individuals. Here, we report a 44-year-old woman who has suffered back pain for more than 20 years. Her symptoms were accompanied by numbness and tingling at the lower limbs. She has been followed with various diagnoses and treatment modalities in different centers. We established the diagnosis of huge thoracal extradural meningeal cysts and followed the patient with conservative approach. Turk J Phys Med Re hab 2012;58:252-4.

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Spinal extradural arachnoid cysts: clinical, radiological, and surgical features

Cited by 106 publications

References 25 publications

Thoracolumbar Extradural Arachnoid Cyst

Thoracolumbar Extradural Arachnoid Cyst

A rare cause of thoracic spinal cord compression by multiple large Tarlov cysts

Spinal Ekstradural Meningeal Kist: Hatalı Radyografik ve Klinik Tanı

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