Subarachnoid-subarachnoid bypass for spinal adhesive arachnoiditis

2014 ◽  
Vol 21 (5) ◽  
pp. 817-820 ◽  
Author(s):  
Toshiya Tachibana ◽  
Tokuhide Moriyama ◽  
Keishi Maruo ◽  
Shinichi Inoue ◽  
Fumihiro Arizumi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Arachnoid Cyst ◽  
Neurological Deterioration ◽  
Gait Disturbance ◽  
Arachnoid Cysts ◽  
Leg Pain ◽  
Thoracic Spinal ◽  
Compressive Myelopathy ◽  
Subarachnoid Cyst

The authors report a case of adhesive arachnoiditis (AA) and arachnoid cyst successfully treated by subarachnoid to subarachnoid bypass (S-S bypass). Arachnoid cysts or syringes sometimes compress the spinal cord and cause compressive myelopathy that requires surgical treatment. However, surgical treatment for AA is challenging. A 57-year-old woman developed leg pain and gait disturbance. A dorsal arachnoid cyst compressed the spinal cord at T7–9, the spinal cord was swollen, and a small syrinx was present at T9–10. An S-S bypass was performed from T6–7 to T11–12. The patient's gait disturbance resolved immediately after surgery. Two years later, a small arachnoid cyst developed. However, there was no neurological deterioration. The myelopathy associated with thoracic spinal AA, subarachnoid cyst, and syrinx improved after S-S bypass.

Intradural arachnoid cysts of the spinal canal associated with intramedullary cysts

1988 ◽  
Vol 68 (4) ◽  
pp. 544-549 ◽  
Author(s):  
Brian T. Andrews ◽  
Philip R. Weinstein ◽  
Mark L. Rosenblum ◽  
Nicholas M. Barbaro
Keyword(s):  
Spinal Cord ◽  
Arachnoid Cyst ◽  
Spinal Surgery ◽  
Spinal Canal ◽  
Late Complication ◽  
Arachnoid Cysts ◽  
Spinal Cord Trauma ◽  
Intramedullary Spinal Cord ◽  
Thoracic Spinal ◽  
Intradural Arachnoid Cysts

✓ Five patients had intradural arachnoid cysts of the thoracic spinal canal associated with syringomyelia or posttraumatic intramedullary spinal cord cysts. Three cases were diagnosed 6 to 18 years after spinal surgery and two 14 to 17 years after spinal cord trauma. In each case, delayed progression of symptoms led to the identification of the lesions. The diagnosis was assisted by the use of myelography and delayed computerized tomography scanning in two cases and by magnetic resonance imaging in all five. In each case, the arachnoid cyst appeared to compress the spinal cord or nerve roots; in three cases, the syrinx cavities appeared to exert a significant mass effect. In the two trauma-related cases, the intramedullary cysts were small and may have represented areas of cystic myelomalacia. In four cases, intraoperative real-time ultrasonography helped to localize the arachnoid and intramedullary cavities. All five patients were treated by fenestration of the arachnoid cyst; additional peritoneal shunting of the cyst was performed in one case and of the intramedullary cavity in three. In one patient, the two lesions appeared to have a balancing effect; after drainage of the arachnoid cyst, the syrinx cavity expanded and had to be treated separately. The neurological deficits were reduced in four patients and stabilized in one. Intradural arachnoid cysts and intramedullary cysts may occur together as a late complication of spinal surgery or spinal cord trauma, and either or both lesions may cause delayed neurological deterioration.

Thoracic arachnoid cyst resection

2014 ◽  
Vol 37 (v2supplement) ◽  
pp. Video4 ◽  
Author(s):  
Harel Deutsch
Keyword(s):  
Spinal Cord ◽  
Arachnoid Cyst ◽  
Surgical Techniques ◽  
Mass Effect ◽  
Cord Compression ◽  
Arachnoid Cysts ◽  
Mri Scan ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Thin Walled

Arachnoid cysts in the spinal cord may be asymptomatic. In some cases arachnoid cysts may exert mass effect on the thoracic spinal cord and lead to pain and myelopathy symptoms. Arachnoid cysts may be difficult to visualize on an MRI scan because the thin walled arachnoid may not be visible. Focal displacement of the thoracic spinal cord and effacement of the spinal cord with apparent widening of the cerebrospinal fluid space is seen. This video demonstrates surgical techniques to remove a dorsal arachnoid cyst causing spinal cord compression. The surgery involves a thoracic laminectomy. The dura is opened sharply with care taken not to open the arachnoid so that the cyst can be well visualized. The thickened arachnoid walls of the cyst are removed to alleviate the compression caused by the arachnoid cyst.The video can be found here: http://youtu.be/pgUrl9xvsD0.

Posterior spinal cord herniation into an extradural thoracic arachnoid cyst: surgical treatment

2006 ◽  
Vol 104 (3) ◽  
pp. 210-211 ◽  
Author(s):  
Farideh Nejat ◽  
Samira Zabihyan Cigarchi ◽  
Syed Shuja Kazmi
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Arachnoid Cyst ◽  
Spinal Cord Herniation

scholarly journals Symptomatic Thoracic Intramedullary Arachnoid Cyst: “A Rare Entity” Report of Two Cases with Short Review of Literature

2019 ◽  
Vol 10 (02) ◽  
pp. 306-311 ◽  
Author(s):  
Naresh Panwar ◽  
Devendra Kumar Purohit ◽  
Somnath Sharma ◽  
Sanjeev Chopra
Keyword(s):  
Arachnoid Cyst ◽  
Case Reports ◽  
Adult Population ◽  
Short Review ◽  
Arachnoid Cysts ◽  
Rare Entity ◽  
Review Of Literature ◽  
Benign Lesions ◽  
Clinicopathological Profile ◽  
Compressive Myelopathy

ABSTRACTSpinal arachnoid cysts are uncommon benign lesions of spine axis and most commonly present as compressive myelopathy. Intramedullary arachnoid cyst is uncommonly seen, hence, not much discussed in literature. Due to rarity of this entity, many questions are yet to be answered and should be addressed properly, particularly related to etiopathogenesis, accustomed course, behavior, differential diagnosis, and the best treatment modality. We report the clinicopathological profile of thoracic intramedullary arachnoid cysts in two adult patients, and present a detailed review of available literature on the spinal intramedullary arachnoid cyst. Most of the literature concerning with intramedullary arachnoid cysts are in the form of case reports from pediatrics population. As far to the best of our knowledge, only a few cases excluding our two were found in both pediatrics and adult population.

scholarly journals A Case of Intradural Arachnoid Cyst with Thoracic Spinal Cord Compression.

1992 ◽  
Vol 41 (2) ◽  
pp. 717-719
Author(s):  
Atsushi Funahashi ◽  
Masateru Ijichi ◽  
Junji Awakuni ◽  
Yuji Tomida ◽  
Masataka Goto
Keyword(s):  
Spinal Cord ◽  
Arachnoid Cyst ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

Dorsal arachnoid web with spinal cord compression: variant of an arachnoid cyst?

2000 ◽  
Vol 93 (2) ◽  
pp. 287-290 ◽  
Author(s):  
Christopher G. Paramore
Keyword(s):  
Spinal Cord ◽  
Subarachnoid Space ◽  
Rare Variants ◽  
Mass Effect ◽  
Arachnoid Cysts ◽  
Thoracic Myelopathy ◽  
Pia Mater ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Thoracic Spinal

✓ Spinal arachnoid cysts are diverticula of the subarachnoid space that may compress the spinal cord; these lesions are most commonly found in the thoracic spine. Two patients who presented with thoracic myelopathy were noted on magnetic resonance imaging to have focal indentation of the dorsal thoracic cord, with syringomyelia inferior to the site of compression. Both patients were found at operation to have discrete arachnoid “webs” tenaciously attached to the dura mater and pia mater. These webs were not true arachnoid cysts, yet they blocked the flow of cerebrospinal fluid (CSF) and caused focal compression of the spinal cord. The mass effect appeared to be the result of a pressure gradient created by the obstruction of CSF flow in the dorsal aspect of the subarachnoid space. Both patients responded well to resection of the arachnoid web. Arachnoid webs appear to be rare variants of arachnoid cysts and should be suspected in patients with focal compression of the thoracic spinal cord.

scholarly journals Intramedullary Arachnoid Cyst of the Cervical Spine: Case Report and Literature Review

2017 ◽  
Vol 36 (04) ◽  
pp. 256-259 ◽  
Author(s):  
Saleh Baeesa ◽  
Abdalrahman Aljameely
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Arachnoid Cyst ◽  
Arachnoid Cysts ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Benign Lesions ◽  
Clinical And Radiological Results

AbstractIntramedullary arachnoid cysts of the spinal cord are extremely rare benign lesions of unclear pathogenesis. To our knowledge, only 21 cases were reported in the literature, 10 of which involved the cervical spine. We report the case of a 47-year-old female who presented with a symptomatic spinal intramedullary arachnoid cyst (SIAC). Magnetic resonance imaging scan of the cervical spine demonstrated an intramedullary arachnoid cyst at C3-C5 level. The patient had a cervical laminectomy and cysto-subarachnoid shunt with rapid and excellent clinical recovery and no recurrence at 2-year follow-up.Intramedullary arachnoid cysts should be considered in the differential diagnosis of intramedullary cystic lesions of the spinal cord. Their pathogenesis and natural history are not well defined in the literature. However, a cysto-subarachnoid shunt can be performed with excellent long-term clinical and radiological results.

Paraplegia after a Routine Lumbar Laminectomy: Report of a Rare Complication and Successful Management

Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 638-640 ◽  
Author(s):  
Patrick L. Valls ◽  
Gill L. Naul ◽  
Steven L. Kanter
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Arachnoid Cyst ◽  
Spinal Canal ◽  
Rare Complication ◽  
Resonance Imaging ◽  
Thoracic Spinal

Abstract Arachnoid cysts of the spinal canal are relatively common lesions that may be either intra- or extradural. These cysts are usually asymptomatic but may produce symptoms by compressing the spinal cord or nerve roots. We report a case in which an intradural thoracic arachnoid cyst became symptomatic after a routine decompressive lumbar laminectomy for spinal stenosis. Myelography revealed no abnormality, although magnetic resonance imaging and computed tomography after myelography demonstrated a mass within the posterior aspect of the thoracic spinal canal associated with anterior displacement and compression of the spinal cord. A change in the flow dynamics of the cerebrospinal fluid probably allowed the development of spinal cord compression due to one of the following: expansion of the cyst, decreased cerebrospinal fluid buffer between the cord and the cyst, or epidural venous engorgement. A concomitant and more cephalad lesion such as an arachnoid cyst should be considered when myelopathic complications arise after lumbar surgery. Magnetic resonance imaging and computed tomography after myelography are useful to demonstrate the additional pathological processes.

Characteristics and surgical results of the distal type of cervical spondylotic amyotrophy

2014 ◽  
Vol 21 (3) ◽  
pp. 411-416 ◽  
Author(s):  
Ryoji Tauchi ◽  
Shiro Imagama ◽  
Hidefumi Inoh ◽  
Yasutsugu Yukawa ◽  
Tokumi Kanemura ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Upper Extremity ◽  
Nerve Root ◽  
Cervical Spondylosis ◽  
Anterior Horn ◽  
Gait Disturbance ◽  
Surgical Results ◽  
Ct Myelography ◽  
Cervical Spondylotic Amyotrophy

Object Cervical spondylosis that causes upper-extremity muscle atrophy without gait disturbance is called cervical spondylotic amyotrophy (CSA). The distal type of CSA is characterized by weakness of the hand muscles. In this retrospective analysis, the authors describe the clinical features of the distal type of CSA and evaluate the results of surgical treatment. Methods The authors performed a retrospective review of 17 consecutive cases involving 16 men and 1 woman (mean age 56.3 years) who underwent surgical treatment for the distal type of CSA. The condition was diagnosed on the basis of cervical spondylosis in the presence of muscle impairment of the upper extremity (intrinsic muscle and/or finger extension muscles) without gait disturbance, and the presence of a compressive lesion involving the anterior horn of the spinal cord, the nerve root at the foramen, or both sites as seen on axial and sagittal views of MRI or CT myelography. The authors assessed spinal cord or nerve root impingement by MRI or CT myelography and evaluated surgical outcomes. Results The preoperative duration of symptoms averaged 11.8 months. There were 14 patients with impingement of the anterior horn of the spinal cord and 3 patients with both anterior horn and nerve root impingement. Twelve patients were treated with laminoplasty (plus foraminotomy in 1 case), 3 patients were treated with anterior cervical discectomy and fusion, and 2 patients were treated with posterior spinal fixation. The mean manual muscle testing grade was 2.4 (range 1–4) preoperatively and 3.4 (range 1–5) postoperatively. The surgical results were excellent in 7 patients, good in 2, and fair in 8. Conclusions Most of the patients in this series of cases of the distal type of CSA suffered from impingement of the anterior horn of the spinal cord, and surgical outcome was fair in about half of the cases.

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