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Intradural spinal arachnoid cysts in adults
Michael Y Wang1, Allan D O Levi, Barth A Green
1Department of Neurological Surgery, University of Southern California, 1200 North State Street, Room #5046, Los Angeles, CA, USA.
Surgical Neurology
|July 17, 2003
Summary
Idiopathic spinal arachnoid cysts can cause significant neurological deficits. Aggressive surgical treatment, including cyst resection and adjuncts like shunting, leads to high rates of cyst and syrinx obliteration.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neurology
Background:
- Idiopathic arachnoid cysts are rare spinal lesions.
- Limited large-scale studies exist on their presentation and management.
Purpose of the Study:
- To describe the clinical presentation and surgical outcomes of intradural spinal arachnoid cysts.
- To evaluate the effectiveness of aggressive surgical management.
Main Methods:
- Retrospective review of 21 adult patients with intradural spinal arachnoid cysts (1994-2001).
- Surgical intervention included laminectomy, cyst fenestration, radical cyst wall resection, and adjuncts such as shunting and duraplasty.
- Intraoperative ultrasonography was utilized.
Main Results:
- Cysts predominantly occurred in the thoracic spine (81%), with both dorsal and ventral locations.
- Surgical treatment resulted in complete cyst resolution in all cases.
- Significant improvement was observed in weakness (100%), hyperreflexia (91%), and incontinence (80%).
- Syringomyelia associated with cysts showed high rates of decrease or complete resolution.
Conclusions:
- Ventral cysts are associated with increased weakness and myelopathic signs.
- Surgical intervention with cyst resection and adjuncts achieves high rates of cyst and syrinx obliteration.
- Neurological improvements in motor function and continence are more likely than resolution of pain and numbness.