[Posterolateral extradural approach for total excision of spinal meningeal cyst (type Ia): case report]

Lateral thoracic meningocele is an uncommon disorder known to occur with high frequency in patients with neurofibromatosis. We report a case not accompanied by neurofibromatosis and describe the operative technique utilizing a posterolateral extradural approach. A 41-year-old man was referred to our cardiologic clinic for severe anterior chest pain. Plain chest X-ray demonstrated an oval mass lesion in the right 9th to 10th thoracic paravertebral region. Magnetic resonance imaging revealed a cystic mass at the 10th thoracic intervetebral foramen without distortion of the spinal cord. Signal intensity of the cystic mass was the same as the cerebrospinal fluid around the spinal cord. In the prone position, laminotomy of the 10th vertebral only was carried out. A pulsatile round mass in continuity with the dura mater was exposed. The wall of the sac, which was thickened with CSF, was identified. The neck of the menigocele was ligated with the help of an aneurysm needle. The patient's severe chest pain disappeared postoperatively.