Nath Pratap Chandra, Mishra Sudhansu Sekhar, Deo Rama Chandra, Satapathy Mani Charan
Department of Neurosurgery, SCB Medical College, Cuttack, Odisha, India.
Department of Neurosurgery, SCB Medical College, Cuttack, Odisha, India.
World Neurosurg. 2016 Jan;85:367.e1-4. doi: 10.1016/j.wneu.2015.09.058. Epub 2015 Sep 30.
Spinal arachnoid cysts are a rare cause of spinal cord compression. Intradural arachnoid cysts are rarer than extradural arachnoid cysts. Spinal arachnoid cysts are mostly congenital in origin. Arachnoid cysts due to trauma, lumbar puncture, or surgery are rarely reported. Most arachnoid cysts are located posterior to the spinal cord in the thoracic regions. The ideal treatment is laminectomy or laminoplasty with puncture, marsupialization, or excision. But the development of a cervico-thoracic spinal intradural extramedullary arachnoid cyst anteriorly located 28 years after laminectomy is a recognizable complication of laminectomy.
We report here a case of a 45-year-old man who underwent C6-T1 laminectomy at the age of 17 years for cervical intervertebral disc prolapse (C6/7, C7/T1) and compressive myelopathy. Twenty-eight years after laminectomy, he developed spastic quadriparesis and was diagnosed with a spinal intradural extramedullary anterior arachnoid cyst at the laminectomy site with compressive myelopathy.
So, although laminectomy with excision is usually practiced to treat spinal arachnoid cysts, laminectomy itself is a cause of development of intradural arachnoid cysts.
脊髓蛛网膜囊肿是脊髓压迫的罕见原因。硬脊膜内蛛网膜囊肿比硬脊膜外蛛网膜囊肿更罕见。脊髓蛛网膜囊肿大多起源于先天性。因创伤、腰椎穿刺或手术导致的蛛网膜囊肿很少见报道。大多数蛛网膜囊肿位于胸段脊髓后方。理想的治疗方法是椎板切除术或椎板成形术并穿刺、袋形缝合或切除。但椎板切除术后28年出现位于颈胸段脊髓硬脊膜内髓外前方的蛛网膜囊肿是椎板切除术可识别的并发症。
我们在此报告一例45岁男性患者,其17岁时因颈椎间盘突出症(C6/7、C7/T1)和压迫性脊髓病接受了C6-T1椎板切除术。椎板切除术后28年,他出现痉挛性四肢瘫,被诊断为在椎板切除部位有一个脊髓硬脊膜内髓外前方蛛网膜囊肿并伴有压迫性脊髓病。
所以,尽管通常采用椎板切除术加切除术来治疗脊髓蛛网膜囊肿,但椎板切除术本身是硬脊膜内蛛网膜囊肿形成的一个原因。