Ido K, Matsuoka H, Urushidani H
Department of Orthopaedic Surgery, Kurashiki Central Hospital, Okayama, Japan.
J Clin Neurosci. 2002 Nov;9(6):694-6. doi: 10.1054/jocn.2002.1138.
Spinal extradural arachnoid cysts are relatively rare, and the pathogenesis is still unclear. Here, we report a 24-year-old woman with a Type I lesion by Nabors' classification (extradural arachnoid cyst without spinal nerve root fiber involvements), who complained of low back pain and right thigh pain, treated surgically using a transforaminal approach. Magnetic resonance imaging (MRI) and myelography showed a large extradural cystic lesion close to the L1 nerve root sleeve, accompanied by moderate L1 nerve root compression and a communication between the extradural cyst and the subarachnoid space. Resection of the cyst wall and closure of the ostium were easily performed by this approach. This procedure resulted in the relief of both low back pain and right thigh pain. Histological examination showed clusters of meningothelial cells, which was a typical feature of arachnoid cysts. Postoperative MRI demonstrated that both the cystic lesion and nerve root compression had disappeared. This transforaminal procedure proved useful for the treatment of a lesion located around a lumbar spinal nerve root.
脊柱硬膜外蛛网膜囊肿相对少见，其发病机制仍不清楚。在此，我们报告一名24岁女性，根据Nabors分类为I型病变（硬膜外蛛网膜囊肿，不累及脊神经根纤维），主诉腰痛和右大腿疼痛，采用经椎间孔入路进行手术治疗。磁共振成像（MRI）和脊髓造影显示，一个靠近L1神经根袖的巨大硬膜外囊性病变，伴有L1神经根中度受压，以及硬膜外囊肿与蛛网膜下腔相通。通过该入路可轻松切除囊肿壁并封闭开口。此手术使腰痛和右大腿疼痛均得到缓解。组织学检查显示有脑膜内皮细胞簇，这是蛛网膜囊肿的典型特征。术后MRI显示囊性病变和神经根受压均已消失。这种经椎间孔手术被证明对治疗位于腰神经根周围的病变有效。
