Spinal Arachnoid Cyst: Treated with Pars Osteotomy and Recapping Laminoplasty - Report of 5 Cases -

Weon Wook Park; Seong Jun Ahn; Ja Gyung Ku; Moo Ho Song; Seong Ho Yoo; Suk Woong Kang

doi:10.4184/jkss.2009.16.3.215

Journal List > J Korean Soc Spine Surg > v.16(3) > 1035857

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Park, Ahn, Ku, Song, Yoo, and Kang: Spinal Arachnoid Cyst: Treated with Pars Osteotomy and Recapping Laminoplasty - Report of 5 Cases -

Original Article

Journal of Korean Spine Surg 2009;16(3):215-221.

Published online: 21 February 2009

DOI: https://doi.org/10.4184/jkss.2009.16.3.215

Spinal Arachnoid Cyst: Treated with Pars Osteotomy and Recapping Laminoplasty - Report of 5 Cases -

Weon Wook Park, M.D., Seong Jun Ahn, M.D.^#,, Ja Gyung Ku, M.D., Moo Ho Song, M.D.^#, Seong Ho Yoo, M.D.^#, Suk Woong Kang, M.D.^#

Spine Center, Korea Hospital, Pusan, Korea

^#Department of Orthopaedic Surgery, Daedong Hospital, Pusan, Korea

Address reprint requests to Seong Jun Ahn, M.D. Department of Orthopaedic Surgery, Daedong Hospital, 530-1 Myungyun 1-Dong, Dongrae-Gu, Pusan, Korea Tel : 82-51- 554-8996, Fax : 82-51-553-7575, E-mail: ahnsjosdept@naver.com

Received 12 November 2008 Accepted 25 August 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spinal arachnoid cysts are a rare disease with an unknown origin. Because of their broad base, a total laminectomy with or without fusion has been the treatment of the choice. We encountered 5 patients with a spinal arachnoid cyst who were treated by recapping laminoplasty after pars osteotomy. This procedure has not been reported in Korea. All patients showed neurological recovery with no recurrence of the cyst. The findings on the stressed plain film confirmed bony union and stability of the posterior element. No complications such as postoperative spinal canal stenosis, facet arthrosis or kyphosis were observed. Among the various surgical options for the extirpation of arachnoid cysts, recapping laminoplasty appears to be a good but technically demanding procedure.

Keywords: Arachnoid cyst, Pars osteotomy, Recapping laminoplasty.

REFERENCES

1). Dastur HM. The radiological appearances of spinal extradural arachnoid cysts. J Neurol Neurosurg Psychiar-ty. 1963; 26:231–235.

2). Rabb CH, McComb JG, Raffel C, Kennedy JG. Spinal arachnoid cysts in the pediatric age group: an association with neural tube defects. J Neurosurg. 1992; 77:369–372.

3). Rimmelin A, Clouet PL, Salatino S, et al. .:. Imaging of thoracic and lumbar spinal extradural arachnoid cysts: report of two cases. Neuroradiology. 1997; 39:203–206.

4). Kulkarin AG, Goel A, Thiruppathy SP, Desai K. Extradural arachnoid cysts: a study of seven cases. British Journal of Neurology. 2004; 18:484–488.

5). Krings T, Lukas R, Reul J, et al. .:. Diagnostic and Therapeutic management of spinal arachnoid cysts. Acta Neurochir. 2001; 143:227–235.

6). Choi JY, Kim SH, Lee WS, Sung KH. Spinal extradural arachnoid cyst. Acta Neurochir. 2006; 148:579–585.

7). 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. 2003; 28:229–233.

8). Cloward RB. Congenital spinal extradural cyst: case report with review of literiture. Ann Surg. 1968; 168:851–864.

9). Hatashita S, Kondo A, Shimizu T, Kurosu A, Ueno H. Spinal extradural arachnoid cyst. Case report. Neurol Med Chir (Tokyo). 2001; 41:318–321.

10). Kawahara N, Tomita K, Shinya Y, et al. .:. Recapping T-saw laminoplasty for spinal cord tumors. 1999; 24:1363–1370.

Figures and Tables%

Fig. 1.

(A) Preoperative MRI and plain X-ray shows type III arachoid cyst from L2 to L5 in the 43-year-old female patient. (B) Intraoperative photograph. we try to remain distal supraspinous ligament attached distal part and complete removal of cyst 9cm in length. (C) Postoperative-6-month X-ray shows good union of pars after recapping and interosseous wiring and pars fixation using screw.

Fig. 2.

(A) Preoperative MRI shows type I arachnoid cyst from T9 to L2 in the 44-year-old female patient. (B) Intraoperative photograph shows remaing distal supraspinous ligament and wire fixation. (C) Postoperative MRI and X-ray shows complete removal of cyst. (D) Postoperative 3 year after recapping laminoplasty shows complete union at the osteotmy levels and shows no instability.

Fig. 3.

Schematic diagram of recapping laminoplasty.

Table 1.

Nabor classification (1994)

Type I	cysts do not contain nerve fibers (extradural)
Type II	cysts do not contain nerve fibers (extradural)
Type III	intradural arachnoid cysts

Table 2.

Summary of the cases of the spinal arachnoid cyst

patient			Nabor classification	lesion	Symtom	Treatment
case	Age	sex	Nabor classification	lesion	Symtom	Treatment
1	38	M	I	T9-L1	myelopathy	recapping laminoplasty, wire fixation
2	57	F	I	T12-L3	radiculopothy, lower leg weakness	recapping laminoplasty, wire fixation
3	43	F	III	L2-L5	radiculopothy, lower leg weakness	recapping laminoplasty, pars screw fixation
4	44	F	I	T9-L2	myelopathy	recapping laminoplasty, wire fixation
5	68	F	III	L3-L5	Racliculopothy lower leg weakness	recapping laminoplasty, wire fixation

TOOLS

Similar articles