Srinivas Balaji, Joseph Vivek, Chacko Geeta, Rajshekhar Vedantam
Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
J Neurosurg Pediatr. 2010 Jun;5(6):586-90. doi: 10.3171/2010.2.PEDS09324.
Spinal extradural cysts do not normally present as a visible paraspinal mass or cause compression of the abdominal organs. The authors describe the case of a 9-month-old boy with multiple spinal extradural cysts. The largest of these cysts was along the right L-2 nerve root with significant extraspinal extension resulting in a visible slow-growing swelling in the right paraspinal region and radiological evidence of compression of the right kidney with hydronephrosis. Another large cyst along the left T-12 root caused radiologically evident compression of the left kidney but to a lesser degree. The patient also had monoparesis of the left lower limb and phenotypic features of Noonan syndrome. The authors performed marsupialization of the cysts, as well as repair of the fistula between the subarachnoid space and the cyst on the right side along the L-2 root and on the left side along the T-12 root. At 1-year follow-up, there was no paraspinal mass and the lower limbs exhibited normal power. Magnetic resonance imaging confirmed marked reduction in the size of the cysts and relief of the renal compression. To the authors' knowledge, their patient is the youngest reported in literature to have a spinal extradural cyst and also the first with the cyst presenting as a paraspinal mass.
脊髓硬膜外囊肿通常不会表现为可见的椎旁肿块，也不会引起腹部器官受压。作者描述了一名9个月大男孩患有多发性脊髓硬膜外囊肿的病例。其中最大的囊肿位于右侧L-2神经根处，有明显的椎管外延伸，导致右侧椎旁区域出现一个可见的生长缓慢的肿块，影像学显示右肾受压并伴有肾积水。另一个位于左侧T-12神经根处的大囊肿在影像学上显示对左肾有明显压迫，但程度较轻。该患者还出现左下肢单瘫以及努南综合征的表型特征。作者对囊肿进行了袋形缝合术，并修复了蛛网膜下腔与右侧沿L-2神经根及左侧沿T-12神经根的囊肿之间的瘘管。在1年的随访中，椎旁无肿块，下肢肌力正常。磁共振成像证实囊肿大小明显缩小，肾压迫得到缓解。据作者所知，他们的患者是文献报道中最年轻的患有脊髓硬膜外囊肿的病例，也是首例囊肿表现为椎旁肿块的病例。
