What is a reasonable surgical procedure for spinal extradural arachnoid cysts: is cyst removal mandatory? Eight consecutive cases and a review of the literature

Abstract

Total excision of EACs may have little benefit in terms of cyst recurrence and clinical outcome. The procedure for EAC resection carries a risk of complications such as kyphosis. If EAC resection is performed, we suggest that a tailored short-level laminotomy be used to allow for the repair of dural defects. Particularly in patients with small EAC, a partial hemilaminectomy with dural defect repair may be a possible method to reduce complications.

Spinal Extradural Arachnoid Cyst

“…A spinal extradural arachnoid cyst (SEAC), which is mostly found at the thoracic spine, is a rare disease, accounting for approximately 1% to 3% of spinal tumors 123456789). SEAC patients are generally men in their 20’s,3) 30’s, or 50’s 6).…”

“…SEAC patients are generally men in their 20’s,3) 30’s, or 50’s 6). SEACs are most commonly found in the middle or lower thoracic spine, and less frequently found in the lumbar region, although they can be detected at any lesion of the spine 1568)…”

“…A SEAC results from a small defect in the dura matter that induces cerebrospinal fluid (CSF) accumulation and arachnoid membrane herniation 12569). The cause of this herniation, which is still under debate, may be either congenital or acquired 13456789).…”

Arachnoid Cysts - Common and Uncommon Clinical Presentations and Radiological Features

“…Spinal arachnoid cysts ( Figure 5) are most common in the thoracic followed by the lumbar spine [28]. Spinal arachnoid cysts, like their intracranial counterparts may exhibit mass effect on adjacent structures resulting in symptoms and neurological signs.…”

“…However, more invasive open or repeated laminectomies are associated with complications such as kyphoscoliosis [28].…”