BACKGROUND Spinal extradural arachnoid cysts(SEACs)are a rare cause of spinal cord compression.Typically,these cysts communicate with the intradural subarachnoid space through a small defect in the dural sac.For sympt...BACKGROUND Spinal extradural arachnoid cysts(SEACs)are a rare cause of spinal cord compression.Typically,these cysts communicate with the intradural subarachnoid space through a small defect in the dural sac.For symptomatic SEACs,the standard treatment is to remove the cyst in total with a(hemi)laminectomy or laminoplasty.We present a rare case of bi-segmental non-communicating SEACs and describe our experience of using an endoscopic minimal access technique to remove bi-segmental non-communicating SEACs.CASE SUMMARY A 79-year-old female presented with pain related to bi-segmental SEACs at the T11-L1 segments.She underwent sequential transforaminal percutaneous endoscopic thoracic cystectomy of the SEACs.Following her first procedure,spinal magnetic resonance imaging demonstrated complete excision of the cyst at the T12-L1 segment.However,the cyst at the T11-T12 segment was still present.Thus,a second procedure was performed to remove this lesion.The patient’s right-sided lumbar and abdominal pain improved significantly postoperatively.Her Japanese Orthopaedic Association score increased from 11 to 25,her visual analogue scale score was reduced from 8 to 1.The physical and mental component summary of the 36-item short-form health survey(SF-36)were 15.5 and 34.375 preoperatively,and had increased to 79.75 and 77.275 at the last follow-up visit,respectively.CONCLUSION Bi-segmental non-communicating SEACs are extremely rare.Endoscopic surgery is a safe,effective,and reliable method for treating these cysts.In the event of bisegmental SEACs,it is important to identify whether both cysts are communicating before surgery,and if not,to remove both cysts separately during the index surgery to avoid re-operation.展开更多
基金Supported by the Program of Scientific Development of Jilin Province,China,No.20190201066JCthe Health Appropriate Technology Poverty Alleviation Project of Jilin Province China,No.2018FP043.
文摘BACKGROUND Spinal extradural arachnoid cysts(SEACs)are a rare cause of spinal cord compression.Typically,these cysts communicate with the intradural subarachnoid space through a small defect in the dural sac.For symptomatic SEACs,the standard treatment is to remove the cyst in total with a(hemi)laminectomy or laminoplasty.We present a rare case of bi-segmental non-communicating SEACs and describe our experience of using an endoscopic minimal access technique to remove bi-segmental non-communicating SEACs.CASE SUMMARY A 79-year-old female presented with pain related to bi-segmental SEACs at the T11-L1 segments.She underwent sequential transforaminal percutaneous endoscopic thoracic cystectomy of the SEACs.Following her first procedure,spinal magnetic resonance imaging demonstrated complete excision of the cyst at the T12-L1 segment.However,the cyst at the T11-T12 segment was still present.Thus,a second procedure was performed to remove this lesion.The patient’s right-sided lumbar and abdominal pain improved significantly postoperatively.Her Japanese Orthopaedic Association score increased from 11 to 25,her visual analogue scale score was reduced from 8 to 1.The physical and mental component summary of the 36-item short-form health survey(SF-36)were 15.5 and 34.375 preoperatively,and had increased to 79.75 and 77.275 at the last follow-up visit,respectively.CONCLUSION Bi-segmental non-communicating SEACs are extremely rare.Endoscopic surgery is a safe,effective,and reliable method for treating these cysts.In the event of bisegmental SEACs,it is important to identify whether both cysts are communicating before surgery,and if not,to remove both cysts separately during the index surgery to avoid re-operation.
