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Related Experiment Video

Updated: May 29, 2026

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

A sacral arachnoid cyst causing holocord syringomyelia.

Sumit Thakar¹, Narayanam Anantha Sai Kiran, Alangar S Hegde

¹Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, Bangalore, India. sumit.thakar@gmail.com

Journal of Neurosurgery. Pediatrics

|September 3, 2011

Summary

Sacral extradural arachnoid cysts are rare and usually asymptomatic. This case highlights a sacral extradural arachnoid cyst causing holocord syringomyelia, a previously undescribed presentation.

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Last Updated: May 29, 2026

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

Area of Science:

Neurosurgery
Spinal Imaging
Neurology

Background:

Spinal extradural arachnoid cysts (ACs) are uncommon, with a rare predilection for the sacrum.
Most sacral ACs are asymptomatic; symptomatic cases typically present with low back pain, radiculopathy, or sphincteric dysfunction.

Observation:

A 15-year-old male presented with fluctuating spastic paraparesis and dissociated sensory loss.
MR imaging revealed a sacral extradural AC (S-2 to S-4) and a holocord syrinx.

Findings:

The patient underwent surgical intervention including laminectomy, cyst fenestration, and partial excision.
Post-operatively, motor and sensory deficits resolved, and MR imaging showed complete syrinx resolution.
The sacral AC also resolved post-operatively, with no dural communication identified.

Implications:

This is the first reported case of a sacral extradural AC causing holocord syringomyelia.
The findings challenge conventional theories of syrinx formation, necessitating new hypotheses.
Highlights the importance of considering rare spinal pathologies in complex neurological presentations.