Journal List > J Korean Soc Spine Surg > v.22(3) > 1076057

J Korean Soc Spine Surg. 2015 Sep;22(3):123-126. Korean.
Published online September 30, 2015.  https://doi.org/10.4184/jkss.2015.22.3.123
© Copyright 2015 Korean Society of Spine Surgery
Surgical Treatment of Spinal Extradural Arachnoid Cyst: A Case Report
Whoan Jeang Kim, M.D., Sang Wook Jeong, M.D., Kun Young Park, M.D., Hwan Il Seong, M.D., Won Cho Kwon, M.D. and Won Sik Choy, M.D.
Department of Orthopedic Surgery, Eulji University School of Medicine, Daejeon, Korea.

Corresponding author: Whoan Jeang Kim, M.D. Department of Orthopedic Surgery, Eulji University Hospital, 95, Dunsanseoro, Seo-gu, Daejeon 302-799, Korea TEL: +82-42-611-3267, FAX: +82-42-259-1289, Email: hjkim@eulji.ac.kr
Received June 16, 2015; Revised July 09, 2015; Accepted August 12, 2015.

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

Study Design

A case report.

Objectives

To report a case of spinal extradural arachnoid cyst.

Summary of Literature Review

Extradural arachonid cysts of the spine are a rare cause of spinal cord and nerve root compression. There are few reports about it, and the etiology remains unclear.

Materials and Methods

The authors performed a clinical and radiographic case review.

Results

A 56-year-old male patient presented with both lower extremity radiating pain and tingling sensation in both feet for four years. His MRI revealed a large, well-demarcated extradural lesion, isointense to cerebrospinal fluid from L1 to L3. We performed dural repair and laminectomy for partial resection of the cyst. The outcome was good in the immediate postoperative period, and the patient made a full recovery without complications.

Conclusions

Surgical treatment should be considered for large spinal extradural arachnoid cysts with neurologic symptoms when conservative treatment does not work.

Keywords: Extradural arachnoid cyst; Dural defect; Surgical treatment

Figures


Fig. 1
A preoperative MRI shows an arachnoid cyst from L1 to L3. A Hypointense T1-weighted image (A) Hyperintense T2-weighted image (B) An axial view (C, D) Shows dural compression.
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Fig. 2
A lateral view of the myelogram. There is no communication between the cyst and subarachnoid space.
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Fig. 3
An intraoperative view showing a grayish translucent cyst.
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Fig. 4
A histopathological examination of the cyst wall showed a fibrocartilagenous layer with a thin layer of simple squamous epithelium.
Click for larger image

References
1. Fortuna A, La Torre E, Ciappetta P. Arachnoid diverticula : a unitary approach to spinal cysts communicating with the subarachnoid space. Acta Neurochir 1977;39:259–268.
2. Cilluffo JM, Gomez MR, Reese DF, et al. Idiopathic ("congenital") spinal arachnoid diverticula. Clinical diagnosis and surgical results. Myo Clin Proc 1998;56:93–101.
3. Fortuna A, La Torre E, Ciappetta P. Arachnoidal diverticula:a unitary approach to spinal cysts communicating with the subarachnoid space. Acta Neurochir 1977;39:259–268.
4. Nabors MW, Pait TG, Byrd EB, et al. Updated assessment and current classification of spinal meningeal cysts. J Neurosurg 1988;68:366–377.
5. Bergland RM. Congenital intraspinal extradural cyst. Report of three cases in one family. J Neurosurg 1968;28:495–499.
6. Liu JK, Cole CD, Kan P, et al. Spinal extradural arachnoid cysts: clinical, radiological, and surgical features. Neurosurg Focus 2007;22:E6.
7. Ersahin Y, Yildizhan A, Seber N. Spinal extradural arachnoid cyst. Childs Nerv Syst 1993;9:250–252.
8. Lee HJ, Cho WH, Han IH, et al. Large thoracolumbar extradural arachnoid cyst excised by minimal skipped hemilaminectomy: A case report. Korean J spine 2013;10:28–31.
9. Neo M, Koyoma T, Sakamoto T. Detection of a dural defect by cinematic magnetic resonance imaging and its selective closure as a treatment for a spinal extradural arachnoid cyst. Spine 2004;29:E426–E430.
10. Stechison MT, Hendrick EB, Cohen E. Spinal extradural arachnoid cyst. Pedatr Neurosci 1989;15:36–38.