Spinal intradural extramedullary arachnoid cysts in adults—operative therapy and clinical outcome

Schmutzer, Michael; Tonn, Joerg‐Christian; Zausinger, Stefan

doi:10.1007/s00701-019-04156-0

Cited by 20 publications

(34 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…SACs are uncommon entities but they may cause neurological symptoms, secondary to spinal cord or nerve roots compression [ 3 , 4 ]. The most common presenting symptoms are back pain (92%), gait disturbance (80%), motor weakness (80%), dysesthesia of the lower limb (64%), paresis (80%), and fine motor skill disturbance (68%) [ 2 , 4 , 9 ]. According to Fam et al, the most common clinical findings are signs of dorsal and cervical myelopathy, in 37% and 32% of cases respectively [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, multilevel laminectomies increase the rate of postoperative complications, such as infections, hemorrhage and spinal instability [ 9 ]. Interlaminar fenestrations or laminoplasty with small dural openings on the cranial and caudal edges can be proposed as alternative surgical technique [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 ] treated 72 patients with idiopathic (88.9%), post-hemorrhagic (8.3%), and post-inflammatory (2.8%) Type III SAC with traditional open techniques [ 2 ]. Their follow up period was 44.8 ± 60.0 months and the authors reported nine patients (12.5%) undergoing a second surgery for recurrence, wound infection or hematoma formation [ 2 ]. The association between the etiology of SAC and the surgical difficulty or clinical outcomes is not clear [ 2 ] and it could be the subject for larger dedicated studies.…”

Section: Discussionmentioning

confidence: 99%

“…Their follow up period was 44.8 ± 60.0 months and the authors reported nine patients (12.5%) undergoing a second surgery for recurrence, wound infection or hematoma formation [ 2 ]. The association between the etiology of SAC and the surgical difficulty or clinical outcomes is not clear [ 2 ] and it could be the subject for larger dedicated studies. Having said that, it remains difficult to make any direct comparison between open and endoscopic techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal arachnoid cysts (SACs) are rare diverticula of the arachnoid membrane of the spinal cord described first by Magendie in 1842 [ 1 ]. They comprise about 1–3% of all primary spinal space-occupying lesions [ 2 ]. From a histological point of view, spinal cysts are classified according to Nabors et al.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Endoscopic treatment of spinal arachnoid cysts

Papadimitriou

Cossu

Maduri

et al. 2021

Heliyon

View full text Add to dashboard Cite

Background/objective Spinal arachnoid cysts (SAC) are intradural lesions, which may provoke a compression of the spinal cord and roots. Endoscopic techniques are increasingly used to minimize the surgical access and the postoperative scar tissue. Shunts may also represent an option. The aim of this paper is to illustrate the technique of endoscopic-assisted fenestration and positioning of a cysto-peritoneal diversion in a thoracic SAC using a flexible endoscope and to perform a systematic literature review on this subject. Material and methods We reported our case and we performed a review of the literature, searching for all the adult cases of Type III SACs in English language treated through endoscopic procedures. Results We found 5 articles matching our search criteria and we included 9 adult patients in our analysis. Six patients were females and the most common localization was the thoracic spine. Six patients underwent selective laminectomies followed by endoscopic fenestration without cyst wall resection. Three patients had a percutaneous endoscopic inspection of the cyst and in two cases a cysto-subarachnoid shunt space was performed. Improvement of pre-operative neurological deficit was reported in six patients, no patients experienced clinical deterioration. The mean follow-up was 22 months and no progression or recurrence was reported. Conclusion The implementation of endoscopy allows a minimally invasive treatments with good visualization of cyst anatomy and precise shunt positioning under real-time guidance. Endoscopy is technically demanding but it can offer similar clinical outcomes when compared to microscopic procedures with a limited rate of post-operative complications. The long-term risk of recurrence should be established by prospective studies.

show abstract