Department of Orthopedics, Stanford University Medical Center, Stanford, CA, USA.
Eur Spine J. 2012 Jun;21 Suppl 4(Suppl 4):S436-40. doi: 10.1007/s00586-011-2005-1. Epub 2011 Sep 4.
To present a rare case of multiple compressive thoracic intradural cysts with pathologic arachnoid ossification, review the literature and present the surgical options. Few reports have identified the existence of arachnoid calcifications and intrathecal cysts causing progressive myelopathy. The literature regarding each of these pathologies is limited to case reports. Their clinical significance is not well studied, although known to cause neurologic sequelae.
An 81-year-old female clinically presents with rapidly progressive myelopathy. Pre-operative magnetic resonance imaging identified multiple compressive thoracic intrathecal cysts. Surgical exploration and decompression of these cysts identified calcified plaques within the arachnoid. Histopathologic examination revealed fibrocalcific tissue undergoing ossification with bone marrow elements.
Due to progressive myelopathy, the thoracic cysts were decompressed and calcified plaques were excised, once identified intra-operatively.
On last examination, the patient's neurologic status had not improved, but had stabilized. The rate of neurologic improvement from excision and decompression is variable, but it may still be warranted in the face of progressive neurologic deficits.
报告一例罕见的多发性胸椎管内硬脊膜下囊肿伴蛛网膜骨化病变，复习相关文献并提出手术选择。少数报道已经确定存在蛛网膜钙化和脊髓内囊肿导致进行性脊髓病。关于这些病变中的每一种的文献仅限于病例报告。尽管已知它们会引起神经后遗症，但它们的临床意义尚未得到很好的研究。
一位 81 岁女性患者出现进行性脊髓病。术前磁共振成像发现多个压迫性胸椎管内脊髓囊肿。对这些囊肿进行手术探查和减压，发现蛛网膜内有钙化斑块。组织病理学检查显示纤维钙化组织正在骨化并伴有骨髓成分。
由于进行性脊髓病，对胸椎管内囊肿进行了减压，并切除了术中发现的钙化斑块。
最后一次检查时，患者的神经状态没有改善，但已经稳定。切除和减压后神经改善的速度是可变的，但在面对进行性神经功能缺损时，仍可能需要手术。
