Inter-dural spinal cyst with acute thoracic compressive myelopathy: anatomical aspects of spinal dura, case report and literature review

Ghimire, Prajwal; Perera, Andrea; Lavrador, José Pedro; Bódi, István; Jarosz, Józef; Grahovac, Gordan; Ashkan, Keyoumars

doi:10.1080/02688697.2020.1834507

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…SAC are classified into primary (congenital or idiopathic) or secondary (acquired). Acquired SAC are more common and can be the result of a trauma, such as a traumatic spinal cord injury, postsurgical arachnoiditis, meningeal infection, haemorrhage, and other insults that cause inflammation and subarachnoid adhesions ( 1 – 3 ).…”

Section: Reflectionmentioning

confidence: 99%

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Correlation of spinal cord injury with development of spinal arachnoid cysts: Two case reports

Raes

Oostra

2021

JRM-CC

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Background Spinal arachnoid cysts are rare entities, which are composed of a duplication in the arachnoid membrane and resultant cerebrospinal fluid collection, which may present with a progressive myelopathy. The most common symptoms caused by spinal cord compression are paraesthesia, neuropathic pain, paresis and gait ataxia. Clinical cases We report here 2 cases from different perspectives of a spinal arachnoid cysts in spinal cord injury. The first case was the occurrence of a spinal cord injury due to compression of a spinal arachnoid cysts causing myelopathy. The second case is a patient who had a traumatic paraplegia for which stabilizing surgery was required and who subsequently developed a spinal arachnoid cysts with neuropathic pain. Both cases required surgery with immediate improvement. However, after a few months both patients needed a revision due to recurrence. Conclusion Spinal arachnoid cysts may present with a heterogeneous clinical picture. If cysts are not clinically apparent, a conservative treatment with careful observation can be a justifiable option. In patients with progressive symptoms, surgery is the gold standard of care. However, the literature describes the need for revision surgery in only 12.5% of cases. Regular follow-up is necessary because both of the patients reported here needed revision surgery. LAY ABSTRACT Spinal cysts are cerebrospinal fluid pockets that may compress the spinal cord. They may present with different symptoms; for example, sensory disorders, pain, loss of strength and difficulty walking. We report here 2 patients with a spinal cord injury with spinal arachnoid cysts. In the case of patients with worsening symptoms, surgery is the gold standard of care. Regular follow-up is necessary; and both patients reported here needed revision surgery.

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Section: Reflectionmentioning

confidence: 99%

“…SAC are classified into primary (congenital or idiopathic) or secondary (acquired). Acquired SAC are the most frequent ( 1 – 3 ). The most common presenting symptoms are paraesthesia, neuropathic pain, paresis and gait ataxia due to spinal cord compression ( 2 ).…”

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confidence: 99%

Correlation of spinal cord injury with development of spinal arachnoid cysts: Two case reports

Raes

Oostra

2021

JRM-CC

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Multiple lumbar spinal inter-dural cysts

Eun¹,

Oh²

2021

Medicine: Case Reports and Study Protocols

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Introduction: Cysts of the spinal canal may be located in the extradural or intradural space. Distinct from these cysts, inter-dural spinal cysts form between the two layers of the spinal dura and contain fluid, including cerebrospinal fluid (CSF) and blood. Inter-dural spinal cysts are extremely rare. We recently encountered a patient presenting with a multiple lumbar spinal inter-dural cysts. Patient concerns: A 58-year-old woman presented with an acute onset of back pain radiating to her left leg. She had no history of surgery or trauma and no other medical illness. Her pain was not relieved by considerable attempts to control it through medication or physical therapy Diagnosis: The magnetic resonance imaging indicated multiple cystic lesions ventral and dorsal to the thecal sac at L2/3 which were compressing the roots of the cauda equina. The contents of the ventral lesion were relatively high signal on T2-weighted images and low-signal on T1-weighted images, suggesting a CSF. Additional magnetic resonsnce myelography was highly suggestive of multiple isolated cysts located in the inter-dural space, with a thin wall separated from the CSF. Interventions: The patient underwent total laminectomy of the 2nd to 3rd lumbar vertebral to expose the cyst. After midline dural incision, inner dural leaflet was found and we could have confirmed the exact position of the cyst was interdural space, and the inner dura was excised. We then retracted the rootlets to find another ventral cyst. A small incision was made in the inner dura overlying the ventral cyst and yellowish fluid was drained. Complete cyst fenestration and excision of the inner dural leaflet was performed. Outcomes: A histopathology report confirmed the cyst to be dura. The patient had complete resolution of symptoms and was asymptomatic 3 years after surgery. Conclusions: Inter-dural cysts occur very rarely. We report the first case of multiple lumbar spinal inter-dural cysts. Acknowledging inter-dural spinal cysts as a type of spinal meningeal cyst is imperative, as this will allow surgeons to avoid unnecessary dural breaches and associated complications.

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Inter-dural spinal cyst with acute thoracic compressive myelopathy: anatomical aspects of spinal dura, case report and literature review

Cited by 2 publications

References 18 publications

Correlation of spinal cord injury with development of spinal arachnoid cysts: Two case reports

Correlation of spinal cord injury with development of spinal arachnoid cysts: Two case reports

Multiple lumbar spinal inter-dural cysts

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