Intramedullary neurenteric cysts of the spine

Lippman, Caleb R.; Arginteanu, Marc S.; Purohit, D P; Naidich, Thomas P.; Camins, Martin B.

doi:10.3171/spi.2001.94.2.0305

Cited by 43 publications

(23 citation statements)

References 17 publications

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“…As reported previously [1, 8, 9], approximately 90% of SNCs are intradural extramedullary in location and fewer than 5% intramedullary. The majority of these cysts are located ventrally to the spinal cord with approximately 50% of them found in the cervical spine.…”

Section: Discussionsupporting

confidence: 72%

“…SNCs, rare congenital lesions [8], may result from inappropriate separation of the embryonic notochordal plate and presumptive endoderm during the third week of embryogenesis, as generally believed [9]. Consistent with their congenital origin, the cystic lesions tend to be associated with various bony anomalies (approximately 50% of prevalence) including fused vertebrae and Klippel–Feil syndrome [10], but those which develop in the elderly population, those located in the cervical spine, and those histologically classified as type A do not [3, 11].…”

Section: Discussionmentioning

confidence: 99%

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A Recurrent Cervical Neurenteric Cyst Treated Anteriorly: Safe, Gross-Total Excision Facilitated by Prophylactic Unilateral Vertebral Artery Exposure, Microdissection, and Spinal Cord Monitoring—A Case Report and Technical Note

Kida¹,

Tani²,

Kawazoe³

et al. 2018

Case Reports in Orthopedics

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This study reports on a 67-year-old woman with partial Brown-Séquard syndrome due to a recurrent cervical neurenteric cyst at C3 to C4. The myelopathic symptoms reappeared 22 years after a previous shunting operation performed posteriorly with a silicone tube connecting the intradural cervical cyst cavity to the subarachnoid space. We have now succeeded in removing the cyst nearly completely with the anterior approach. The surgical procedure consisted of right vertebral artery exposure at C3 and C4 and a subtotal corpectomy of C3 followed by microdissection of the cyst, duraplasty, and iliac strut graft fusion. Spinal cord monitoring with motor-evoked potential studies helped us safely dissect the cyst wall tightly adhering to the spinal cord. Duraplasty with Gore-Tex patch-grafting in conjunction with postoperative lumbar subarachnoid drainage worked well in preventing a spinal fluid fistula. At two years after surgery, the patient showed a nearly complete return of function without any recurrence of the cyst.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

A Recurrent Cervical Neurenteric Cyst Treated Anteriorly: Safe, Gross-Total Excision Facilitated by Prophylactic Unilateral Vertebral Artery Exposure, Microdissection, and Spinal Cord Monitoring—A Case Report and Technical Note

Kida¹,

Tani²,

Kawazoe³

et al. 2018

Case Reports in Orthopedics

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“…They may be secondary to ependymoma, astrocytoma, and hemangioblastoma [1‐3]. Benign intradural cysts usually are isointense with spinal fluid on MRI and show no enhancement with gadolinium–diethylenetriamine penta‐acetic acid [3‐6]. The lack of enhancement helps to differentiate such cysts from neoplastic lesions [4‐6].…”

Section: Discussionmentioning

confidence: 99%

“…Benign intradural cysts usually are isointense with spinal fluid on MRI and show no enhancement with gadolinium–diethylenetriamine penta‐acetic acid [3‐6]. The lack of enhancement helps to differentiate such cysts from neoplastic lesions [4‐6]. Benign intradural spinal cysts are histologically classified as arachnoid, enterogenousand ependymal cysts [7].…”

Section: Discussionmentioning

confidence: 99%

Conus Medullaris Enterogenous Cyst

Felix

Seidel

Murphy

et al. 2012

PM&R

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INTRODUCTIONThis report discusses the unique presentation and outcome of a patient with a conus medullaris enterogenous cyst. The incidence of enterogenous cysts, differential diagnosis, imaging, presentation, and management are discussed. The unique aspects of this case presentation include a patient of advanced age with an atypical enterogenous cyst at clinical presentation and postoperative motor recovery despite prolonged cord compression. CASE PRESENTATIONA 66-year-old white woman presented with a 2-year history of constant pain in her left anteromedial thigh and knee. She had experienced multiple falls due to left knee buckling, although she had experienced no specific left knee injury to cause the weakness. Due to this left lower extremity weakness, she required a walker to ambulate. There was no history of trauma, fever, back pain, recent weight loss, paresthesias, or changes in bowel or bladder. Her medical history was significant for obesity and hypothyroidism. Review of systems was otherwise unremarkable. Results of a physical examination revealed visible left thigh atrophy (thigh circumference was 6 cm smaller on the left side). Manual muscle testing demonstrated left iliopsoas and quadriceps strength of 2/5. Bilateral gluteus medius, hamstring, anterior tibialis, gastrocsoleus complex, and extensor hallucis longus strength, and right iliopsoas and quadriceps strength were all 5/5. Sensory examination was normal for light touch, pinprick, and vibration, with the exception of anesthesia in the left anterior and lateral thigh that extended to the proximal medial tibial region. Deep tendon reflexes were normal, with the exception of an absent left quadriceps reflex. Toes were downgoing bilaterally to plantar stimulation.Electrodiagnostic testing of the bilateral lower extremities and related paraspinals revealed a left L2-L4 radiculopathy (anterior limb muscles and posterior paraspinal denervation evident). There was no evidence of right lumbosacral radiculopathy or plexopathy. Magnetic resonance imaging (MRI) of the lumbar spine without contrast performed to evaluate for a presumed diskal-structural lesion revealed a cystic structure in the distal cord-conus medullaris. A thoracic spine MRI with contrast demonstrated an expansile lesion of T1 and T2 prolongation signal in the distal cord-conus medullaris that was approximately 15 ϫ 15 ϫ 40 mm in the anterior and posterior, transverse, and cephalocaudad diameter, without pathologic contrast enhancement (Figure 1).Initial conservative treatment included physical therapy, adaptive equipment, and observation because the patient was concerned about potential paraplegia with surgical intervention on the distal spinal cord. Needle electromyogram examination demonstrated the presence of active denervation of the left anterior thigh musculature. Physical therapy was initiated to strengthen the involved musculature, to instruct in compensatory gait mechanics and/or assistive device use, and to prevent falls. The strength of the left anterior thigh musculature did...

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“…These pathological entities most likely develop from an anomalous connection between the primitive endoderm and ectoderm. Our case report is even rarer with a neurenteric cyst located within the spinal cord only reported nine other times in the literature (Lippman et al, 2001). …”

Section: Discussionmentioning

confidence: 93%

Neurenteric cyst: Case report and a review of the potential dysembryology

Tubbs¹,

Salter²,

Oakes³

2005

Clinical Anatomy

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We report a 13-year-old female who presented to an outside emergency room following blunt trauma to the head. As part of her evaluation, an unenhanced CT of the face and radiographs of the cervical spine were performed. She was referred to our clinic with "abnormal" imaging. Radiographs revealed dysmorphic cervical spine and ventral clefting of the vertebral bodies from C7-T2. A subsequent MRI was obtained that demonstrated a large spinal cord mass. MRI demonstrated an unenhanced intramedullary mass of the cervicothoracic spinal cord measuring approximately 1.5 cm in greatest axial diameter. Surgical exploration of her intraspinal mass revealed a neurenteric cyst. Spinal neurenteric cysts are categorized in the spectra of occult spinal dysraphism and most likely arise from incomplete separation of the developing notochord and foregut in the embryo. We discuss potential etiologies for the formation of such cysts. The clinician should consider neurenteric cysts in their differential diagnosis of patients with spinal dysraphism and/or intraspinal masses.

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Intramedullary neurenteric cysts of the spine

Cited by 43 publications

References 17 publications

A Recurrent Cervical Neurenteric Cyst Treated Anteriorly: Safe, Gross-Total Excision Facilitated by Prophylactic Unilateral Vertebral Artery Exposure, Microdissection, and Spinal Cord Monitoring—A Case Report and Technical Note

A Recurrent Cervical Neurenteric Cyst Treated Anteriorly: Safe, Gross-Total Excision Facilitated by Prophylactic Unilateral Vertebral Artery Exposure, Microdissection, and Spinal Cord Monitoring—A Case Report and Technical Note

Conus Medullaris Enterogenous Cyst

Neurenteric cyst: Case report and a review of the potential dysembryology

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