Posttraumatic spinal cord cysts: clinical features and characterization with metrizamide computed tomography

Area of Science:

• Neurosurgery
• Neurology
• Radiology

Background:

• Posttraumatic spinal cord cysts (PTSCC) can develop months to years after severe spinal cord injury.
• These cysts often present with new or worsening neurological deficits.

Purpose of the Study:

• To clinically evaluate patients with PTSCC.
• To characterize the radiographic morphology of PTSCC using metrizamide computed tomography (MCT).
• To correlate cyst characteristics with spinal cord anatomy and cerebrospinal fluid dynamics for surgical planning.

Main Methods:

• Clinical evaluation of sixteen patients with PTSCC.
• Metrizamide computed tomography (MCT) to visualize cyst characteristics.
• Correlation of cyst location, enlargement, and morphology with spinal cord anatomy and CSF dynamics.

Main Results:

• PTSCC development was independent of injury characteristics (location, type, severity) or time interval.
• MCT revealed cysts most commonly in normal or atrophic cords, often multiple and dorsal.
• Cyst morphology varied in width and position along the cord's length.
• Cyst location and enlargement correlated with spinal cord anatomy and CSF dynamics.

Conclusions:

• Radiographic morphology of PTSCC is critical for surgical planning.
• Cyst-to-subarachnoid space shunting is an effective treatment for relieving symptoms associated with PTSCC.