Cervical Ventral Epithelial Cyst Treated by Anterior Corpectomy —Case Report—

Abstract

A 15-year-old boy presented with a cervical ventral epithelial cyst manifesting as intractable cervical pain. Neurological examination revealed weakness of his left grasp and increased deep tendon reflexes. The anterior approach was selected because the lesion was located directly ventral to the spinal cord. He underwent C4-5 anterior corpectomy and subtotal resection of the cyst wall. He made a good recov ery without additional deficits. Most previously reported cases have been treated using the posterior ap proach despite the ventral location of the lesion. The anterior approach offers a safer and more effec tive means of treating such lesions because it allows direct access to the lesion without manipulation of the spinal cord.

Ventral Intradural Endodermal Cyst in the Cervical Spine Treated With Anterior Corpectomy -Case Report-

“…6) Therefore, the surgical strategy concerning the approach route and extent of removal of the cyst wall remains controversial. Tables 1 and 2 show a summary of previous cases of endodermal cysts treated via the posterior 1,4,13,15,17,18,20,21,23) or anterior approach 2,3,5,6,8,9,11,14,16,19) including the present case. Three of 4 cases of recurrence of the cyst were treated via the posterior approach, and the other case was treated via the anterior approach though the intervertebral disc space.…”

“…No severe surgery-related complications associated with the anterior approach have been reported. 2,3,5,6,8,9,11,14,16,19) Thus, the anterior approach is safe for reaching a cyst located ventral to the spinal cord, as the relationship between the cyst wall and the spinal cord can be clearly visualized. Moreover, although adequate removal of the cyst wall of endodermal cysts is difficult to perform in the deep, narrow operative field that is obtained in the discectomy approach, this is not hold true for corpectomy.…”

“…24) Endodermal cyst is also called neurenteric cyst. Such cysts are generally located ventral to the spinal cord, and were mainly treated surgically via an anterior 2,3,5,6,8,9,11,14,16,19) or posterior approach. 1,4,13,15,17,18,20,21,23) However, these techniques have not been directly compared, and the surgical indications and strategy for such cysts remain controversial.…”