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Intradural Thoracic Arachnoid Cyst Fenestration for Spinal Cord Compression: A Case Illustration and Video
James Ebot1, Ricardo Domingo1, Henry Ruiz Garcia2
1Neurosurgery, Mayo Clinic, Jacksonville, USA.
Cureus
|February 13, 2020
Summary
Spinal intradural arachnoid cysts, though rare, can cause significant neurological deficits. Surgical fenestration of these benign cysts can lead to substantial recovery of function.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Spinal intradural arachnoid cysts are uncommon, benign lesions.
- They can be primary or secondary to inflammation, presenting varied symptoms from asymptomatic to myelopathy.
Observation:
- An 80-year-old female presented with rapidly progressing myelopathy symptoms including back pain, incontinence, and gait disturbance.
- Thoracic spine MRI revealed a large extra-axial cystic lesion compressing the spinal cord from T4 to T10.
Findings:
- Microsurgical fenestration of the arachnoid cyst was performed via two separate thoracic laminectomies (T4-T5 and T9-T10) under neurophysiologic monitoring.
- Intraoperative fluoroscopy and ultrasound aided in lesion localization.
Implications:
- The patient experienced no neurological complications and showed significant improvement in ambulation and strength post-surgery.
- This case highlights the efficacy of surgical intervention for symptomatic spinal intradural arachnoid cysts.
