A symptomatic spinal extradural arachnoid cyst with lumbar disc herniation
Yoshinori Kadono1, Takamichi Yuguchi2, Yu-Ichiro Ohnishi1
1Department of Neurosurgery, Osaka University School of Medicine, Osaka 565-0871, Japan.
Case Reports in Orthopedics
|April 11, 2015
Summary
A rare spinal epidural arachnoid cyst (EAC) caused significant symptoms in a patient with a lumbar disc herniation. Surgical intervention resolved the patient's pain, highlighting the impact of co-occurring conditions.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Radiology
Background:
- Spinal epidural arachnoid cysts (EACs) are uncommon, typically asymptomatic, and often found in the thoracic spine.
- Lumbar EACs are particularly rare and usually not associated with trauma or disc herniation.
Purpose of the Study:
- To report a unique case of a posttraumatic symptomatic lumbar spinal epidural arachnoid cyst.
- To investigate the interplay between EAC, lumbar disc herniation, and symptom development.
Main Methods:
- Case report of a 22-year-old male with back pain and sciatica post-trauma.
- Diagnostic imaging including MRI and CT myelography to identify the cyst and herniation.
- Surgical excision of the EAC and lumbar disc herniation with dural defect repair.
Main Results:
- The patient presented with right L5 radiculopathy secondary to a lumbar EAC and L4-L5 disc herniation.
- Imaging confirmed the cyst compressing the L5 nerve root against the herniated disc.
- Complete surgical excision and repair led to symptom resolution.
Conclusions:
- Posttraumatic symptomatic lumbar spinal epidural arachnoid cysts are exceptionally rare.
- Comorbid conditions like lumbar disc herniation can significantly influence EAC symptom presentation and progression.
- While many EACs are asymptomatic, associated spinal pathologies can necessitate surgical intervention.
