Marsupialisation of an arachnoid cyst in a dog

Abstract

A seven‐month‐old West Highland white terrier was presented with hindlimb ataxia and paraparesis. Radiographic studies revealed an arachnoid cyst at thoracic vertebrae 12 and 13. A dorsal laminectomy and durotomy were performed to decompress the spinal cord. The cyst was marsupialised by suturing the dura mater to the edge of the laminectomy defect. There were no postoperative complications and the dog improved to normality.

Dura mater marsupialisation and outcome in a cat with a spinal subarachnoid pseudocyst: a case report

“…An altered cerebrospinal fluid (CSF) flow pattern along the spinal subarachnoid space may contribute to the formation of these pseudocysts (DeLahunta and Glass 2009b), although their pathophysiology and the associated myelopathy are poorly understood. Spynal subarachnoid pseudocysts are well known and have previously been described in dogs (Bently et al 1991;Dyce et al 1991;McKeen and Renwick 1994;Hardie et al 1996;Bagley et al 1997;Mauler et al 2012). However, there are only a few reports which describe their occurrence in cats (Shamir et al 1997;Vignoli et al 1999;Schmidt et al 2007;Sugiyama and Simpson 2009).…”

“…In this way sufficient space is provided for the suture anchors to prevent excessive traction on the meningeal flaps by the suture, in order to prevent relapse and spinal stress. In dogs, the time of recurrence ranges from five months to four years (McKeen and Renwick 1994;Frykman 1999;Gnirs et al 2003;Jurina and Grevel 2004) and in cats it ranges from 10 months to four years (Schmidt et al 2007;Sugiyama and Simpson 2009). Although recurrence following utilisation of the marsupialisation technique was described (Schmidt et al 2007), this procedure still represents the best treatment for this spinal disease (Skeen et al 2003).…”

“…Simple durotomy or durectomy represent good techniques for treatment of subarachnoid pseudocysts but, in the authors' opinion, neither maintain persistent drainage of the pseudocysts since they often show recurrence (Frykman 1999;Sugiyama and Simpson 2009 (Palmer 1974), whilst in cats, to our knowledge, only one case was briefly described (Schmidt et al 2007). According to some authors (McKeen and Renwick 1994), this technique may represent a challenge for the surgeon, because the small size of the patient may make complicate the fixing of the dura mater edges to the periarticular soft tissues. To overcome this problem, it is crucial not to detach the soft tissues and periosteum too widely.…”

“…This allowed the identification of the previous fracture of the L1 vertebra as a possible causative factor. The treatment of subarachnoid pseudocysts typically requires a surgical approach (Sharp and Wheeler 2009) that considers two different entries to the spinal cord: dorsal laminectomy (McKeen and Renwick 1994;Frykman 1999;Sugiyama and Simpson 2009;Ricci et al 2011) or hemilaminectomy (Shamir et al 1997;Gnirs et al 2003;Schmidt et al 2007). Two different treat- ments can be performed, the simple fenestration technique (durotomy or durectomy) (Shamir et al 1997;Frykman 1999;Jurina and Grevel 2004;Sugiyama and Simpson 2009;Ricci et al 2011), or durotomy associated with dura mater marsupialisation (McKeen and Renwick 1994;Jurina and Grevel 2004;Schmidt et al 2007;Sharp and Wheeler 2009).…”

“…Two different treat- ments can be performed, the simple fenestration technique (durotomy or durectomy) (Shamir et al 1997;Frykman 1999;Jurina and Grevel 2004;Sugiyama and Simpson 2009;Ricci et al 2011), or durotomy associated with dura mater marsupialisation (McKeen and Renwick 1994;Jurina and Grevel 2004;Schmidt et al 2007;Sharp and Wheeler 2009). As many authors suggest (McKeen and Renwick 1994;Sugiyama and Simpson 2009;Ricci et al 2011), we performed a dorsal laminectomy and marsupialisation, with consideration of the better reported outcome (McKeen and Renwick 1994;Jurina and Grevel 2004). Simple durotomy or durectomy represent good techniques for treatment of subarachnoid pseudocysts but, in the authors' opinion, neither maintain persistent drainage of the pseudocysts since they often show recurrence (Frykman 1999;Sugiyama and Simpson 2009 (Palmer 1974), whilst in cats, to our knowledge, only one case was briefly described (Schmidt et al 2007).…”