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Clinical Outcomes of Surgical Treatment for Arachnoid Web: A Case Series

Takashi Hirai1, Takashi Taniyama2, Toshitaka Yoshii1

  • 1Department of Orthopedic Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.

Spine Surgery and Related Research
|August 23, 2019
PubMed
Abstract

Insights

Surgical treatment for thoracic spinal arachnoid web (AW) improved patient locomotion and T-JOA scores. While some symptoms like numbness and bladder-bowel dysfunction showed improvement, they were not fully resolved in all cases.

Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Neurology

Background:

  • Arachnoid web (AW) is a rare thoracic spinal cord compression cause.
  • Only 14 AW cases reported; surgical outcomes are largely unknown.
  • AW can lead to syringomyelia and significant neurological deficits.

Purpose of the Study:

  • To evaluate the clinical and radiological outcomes of surgical treatment for thoracic spinal arachnoid web.
  • To assess the impact of surgical intervention on patient neurological function.

Main Methods:

  • Retrospective review of 5 patients treated surgically for thoracic AW.
  • Clinical outcomes assessed using the thoracic Japanese Orthopaedic Association (T-JOA) score.
  • Preoperative and postoperative imaging analysis.

Main Results:

  • All patients presented with spastic gait and lower extremity numbness; 2 had bladder-bowel dysfunction (BBD).
  • Surgery involved fenestration and web resection without instrumentation.
  • Significant improvements noted in locomotion and T-JOA scores; partial improvement in numbness and BBD.

Conclusions:

  • Surgical treatment for thoracic AW can restore cerebrospinal fluid flow dynamics.
  • Neurological recovery, particularly in locomotion, is achievable following surgical intervention.
  • Further research is needed to fully understand long-term outcomes for all symptoms.
Keywords:
arachnoid webscalpel signsurgical treatmentsyringomyeliathoracic spine

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