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Thoracolumbar extradural arachnoid cysts: a study of 14 consecutive cases

 Jae Keun Oh  ;  Dong Youp Lee  ;  Tae Yup Kim  ;  Seong Yi  ;  Yoon Ha  ;  Keung Nyun Kim  ;  Hyunchul Shin  ;  Dong Seok Kim  ;  Do Heum Yoon 
 ACTA NEUROCHIRURGICA, Vol.154(2) : 341-348, 2012 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Arachnoid Cysts/diagnosis* ; Arachnoid Cysts/surgery* ; Child ; Female ; Humans ; Laminectomy ; Lumbar Vertebrae/diagnostic imaging* ; Lumbar Vertebrae/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Diseases/diagnosis* ; Spinal Cord Diseases/surgery* ; Thoracic Vertebrae/diagnostic imaging* ; Thoracic Vertebrae/surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult
Arachnoid cyst ; Clinical outcome ; Extradural ; Thoracolumbar
BACKGROUND: To investigate characteristic clinical and radiological features of extradural arachnoid cysts (EDACs) in the thoracolumbar region, a retrospective review of medical records and imaging studies was performed. EDACs are well known but relatively rare lesions in the thoracolumbar spinal canal. The most common site is the lower thoracic spine, and it may cause neurological symptoms by compressing the spinal cord or nerve root. In this study, the pathogenesis, symptomatology, diagnostic approach, and surgical management of EDACs will be discussed. METHODS: We studied 14 consecutive patients who were surgically treated for EDACs in the thoracolumbar region at our institute between March 2000 and January 2011. The history, clinical presentations, image findings, operative findings, and surgical outcomes of these patients were retrospectively analyzed. The mean follow-up period was 28 months (range: 6-72 months). RESULTS: Progressive motor weakness was the predominant symptom in all patients. Nine patients had radicular leg pain and back pain in the thoracolumbar area. On MRI, the cyst compressed the dural sac and spinal cord posteriorly typically with bilateral foraminal extensions. On radiological study, a communication point with the subarachnoid was hardly observed. The surgical treatment of EDACs included complete resection of the walls and closing the communicating point with the subarachnoid space. All patients showed excellent outcomes according to Odom's criteria without recurrence. One CSF leakage and one postoperative hematoma were noted. CONCLUSIONS: Thoracolumbar EDAC patients presented paraparesis and leg pain. Complete excision and closing the communicating point with the subarachnoid space were the choices of treatment, and the outcomes were favorable.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keung Nyun(김긍년)
Kim, Dong Seok(김동석)
Kim, Tae Yup(김태엽)
Oh, Jae Keun(오재근)
Yoon, Do Heum(윤도흠) ORCID logo https://orcid.org/0000-0003-1452-5724
Yi, Seong(이성)
Ha, Yoon(하윤)
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