Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Spinal Extradural Arachnoid Cyst

  • Choi, Seung Won (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seong, Han Yu (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Roh, Sung Woo (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2013.02.01
  • Accepted : 2013.09.30
  • Published : 2013.10.28
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Abstract

Spinal extradural arachnoid cyst (SEAC) is a rare disease and uncommon cause of compressive myelopathy. The etiology remains still unclear. We experienced 2 cases of SEACs and reviewed the cases and previous literatures. A 59-year-old man complained of both leg radiating pain and paresthesia for 4 years. His MRI showed an extradural cyst from T12 to L3 and we performed cyst fenestration and repaired the dural defect with tailored laminectomy. Another 51-year-old female patient visited our clinical with left buttock pain and paresthesia for 3 years. A large extradural cyst was found at T1-L2 level on MRI and a communication between the cyst and subarachnoid space was illustrated by CT-myelography. We performed cyst fenestration with primary repair of dural defect. Both patients' symptoms gradually subsided and follow up images taken 1-2 months postoperatively showed nearly disappeared cysts. There has been no documented recurrence in these two cases so far. Tailored laminotomy with cyst fenestration can be a safe and effective alternative choice in treating SEACs compared to traditional complete resection of cyst wall with multi-level laminectomy.

Keywords

References

  1. Choi JY, Kim SH, Lee WS, Sung KH : Spinal extradural arachnoid cyst. Acta Neurochir (Wien) 148 : 579-585; discussion 585, 2006 https://doi.org/10.1007/s00701-006-0744-2
  2. Doita M, Nishida K, Miura J, Takada T, Kurosaka M, Fujii M : Kinematic magnetic resonance imaging of a thoracic spinal extradural arachnoid cyst : an alternative suggestion for exacerbation of symptoms during straining. Spine (Phila Pa 1976) 28 : E229-E233, 2003
  3. Hatashita S, Kondo A, Shimizu T, Kurosu A, Ueno H : Spinal extradural arachnoid cyst--case report. Neurol Med Chir (Tokyo) 41 : 318-321, 2001 https://doi.org/10.2176/nmc.41.318
  4. Kim IS, Hong JT, Son BC, Lee SW : Noncommunicating spinal extradural meningeal cyst in thoracolumbar spine. J Korean Neurosurg Soc 48 : 534-537, 2010 https://doi.org/10.3340/jkns.2010.48.6.534
  5. Kim K, Chun SW, Chung SG : A case of symptomatic cervical perineural (Tarlov) cyst : clinical manifestation and management. Skeletal Radiol 41 : 97-101, 2012 https://doi.org/10.1007/s00256-011-1243-y
  6. Lee CH, Hyun SJ, Kim KJ, Jahng TA, Kim HJ : What is a reasonable surgical procedure for spinal extradural arachnoid cysts : is cyst removal mandatory? Eight consecutive cases and a review of the literature. Acta Neurochir (Wien) 154 : 1219-1227, 2012 https://doi.org/10.1007/s00701-012-1356-7
  7. Lee MC, Lee JK, Wee SC, Kim TS, Kim JH, Kim SH, et al. : Spinal extradural meningeal cyst : case report. J Korean Neurosurg Soc 27 : 407-411, 1998
  8. Miyamoto M, Kim K, Matsumoto R, Isobe M, Isu T : Utility of preoperative magnetic resonance imaging myelography for identifying dural defects in patients with spinal extradural arachnoid cysts : case report. Neurosurgery 59 : E941; discussion E941, 2006 https://doi.org/10.1227/01.NEU.0000232659.56174.28
  9. Nabors MW, Pait TG, Byrd EB, Karim NO, Davis DO, Kobrine AI, et al. : Updated assessment and current classification of spinal meningeal cysts. J Neurosurg 68 : 366-377, 1988 https://doi.org/10.3171/jns.1988.68.3.0366
  10. Netra R, Min L, Shao Hui M, Wang JC, Bin Y, Ming Z : Spinal extradural meningeal cysts : an MRI evaluation of a case series and literature review. J Spinal Disord Tech 24 : 132-136, 2011 https://doi.org/10.1097/BSD.0b013e3181e47b47
  11. Neulen A, Kantelhardt SR, Pilgram-Pastor SM, Metz I, Rohde V, Giese A : Microsurgical fenestration of perineural cysts to the thecal sac at the level of the distal dural sleeve. Acta Neurochir (Wien) 153 : 1427-1434; discussion 1434, 2011 https://doi.org/10.1007/s00701-011-1043-0
  12. Oh JK, Lee DY, Kim TY, Yi S, Ha Y, Kim KN, et al. : Thoracolumbar extradural arachnoid cysts : a study of 14 consecutive cases. Acta Neurochir (Wien) 154 : 341-348; discussion 348, 2012 https://doi.org/10.1007/s00701-011-1110-6
  13. Payer M, Brühlhart K : Spinal extradural arachnoid cyst : review of surgical techniques. J Clin Neurosci 18 : 559-560, 2011 https://doi.org/10.1016/j.jocn.2010.07.126

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