Subarachnoid-subarachnoid bypass for spinal adhesive arachnoiditis

Area of Science:

• Neurosurgery
• Spinal Surgery

Background:

• Adhesive arachnoiditis (AA) and arachnoid cysts can lead to spinal cord compression and myelopathy.
• Surgical treatment for AA is particularly challenging due to adhesions.
• Subarachnoid to subarachnoid bypass (S-S bypass) is a potential surgical option.

Observation:

• A 57-year-old female presented with leg pain and gait disturbance.
• Imaging revealed a dorsal arachnoid cyst compressing the thoracic spinal cord (T7-9) with associated swelling and a small syrinx (T9-10).

Findings:

• An S-S bypass was successfully performed from T6-7 to T11-12.
• The patient experienced immediate resolution of gait disturbance post-surgery.
• Two years later, a new cyst appeared without neurological decline, indicating sustained improvement.

Implications:

• S-S bypass offers a viable treatment for complex spinal conditions like AA with cysts and syringomyelia.
• This technique may alleviate spinal cord compression and improve neurological function.
• Further research into S-S bypass for spinal pathologies is warranted.