Spinal arachnoid cysts in adults: Diagnosis and management. A single-center experience

摘要: OBJECTIVEAdult spinal arachnoid cysts (SACs) are rare entities of indistinct etiology that present with pain or myelopathy. Diagnosis is made on imaging studies varying degrees specificity. In symptomatic cases, the standard treatment involves surgical exploration and relief neural tissue compression. The aim this study was to illustrate features SACs in adults, management, outcomes.METHODSThe authors searched medical records for all adults 10-year period ending December 2016. Radiology pathology reports were reviewed exclude other spine cystic disorders. Recurrent previously treated patients excluded. Demographic variables (age, sex) clinical presentation (symptoms, duration, history infection trauma, examination findings) extracted. Radiological collected from radiology direct interpretation studies. Operative media accurately describe technique. Finally, patient-reported outcomes at every clinic visit using SF-36.RESULTSThe authors' search identified 22 (mean age 53.5 years). Seventeen women, representing an almost 3:1 sex distribution. Symptoms comprised back (n = 16, 73%), weakness 10, 45%), gait ataxia 11, 50%), sphincter dysfunction 4, 18%). mean duration symptoms 15 months. Seven (32%) exhibited signs All underwent preoperative MRI; addition, 6 CT myelography. located thoracic 17, 77%), less commonly lumbar 3, 14%) cervical/cervicothoracolumbar region 2, 9%). Based findings, interpreted as intradural extradural 6, 27%), ventral cord herniation 9%); findings 3 (14%) inconclusive. Nineteen consisting laminoplasty addition cyst resection 13, 68%), ligation connecting pedicle 21%), fenestration/marsupialization 11%). Postoperatively, followed up average 8.2 months (range 2-30 months). Postoperative MRI showed complete resolution SAC 14 16 patients. Patient-reported improvement SF-36 parameters. One patient suffered a delayed wound infection.CONCLUSIONSIn suggestive cyst, choice. Treatment usually well tolerated, carries low risks, provides best chances optimal recovery.