Wali Arvin R, Birk Harjus S, Martin Joel, Santiago-Dieppa David R, Ciacci Joseph
Neurosurgery, University of California, San Diego, La Jolla, USA.
Cureus. 2019 Jun 19;11(6):e4945. doi: 10.7759/cureus.4945.
Dorsal thoracic arachnoid webs are rare clinical entities caused by a thickened intradural extramedullary band of arachnoid tissue that compresses the spinal cord, and often present with progressive back pain, paresthesias, and lower extremity weakness. In this report, we review the radiographic features of the "Scalpel Sign" and describe the case of a 47-year-old male that failed conservative therapy and was found to have dorsal thoracic arachnoid web. The patient underwent laminectomy and microsurgical release of the compressing arachnoid band. Postoperatively, the patient had complete resolution of his pain. Intraoperatively, the somatosensory evoked potentials were improved once the band was released. The prompt diagnosis of dorsal arachnoid webs remains critical because surgical treatment arrests and potentially reverses the pathology.
胸段硬脊膜背侧蛛网膜网是一种罕见的临床病症，由增厚的硬脊膜内髓外蛛网膜组织带压迫脊髓引起，常表现为进行性背痛、感觉异常和下肢无力。在本报告中，我们回顾了“手术刀征”的影像学特征，并描述了一例47岁男性患者的病例，该患者保守治疗失败，被发现患有胸段硬脊膜背侧蛛网膜网。患者接受了椎板切除术和压迫性蛛网膜带的显微手术松解。术后，患者疼痛完全缓解。术中，一旦松解该带，体感诱发电位就得到改善。胸段蛛网膜网的及时诊断仍然至关重要，因为手术治疗可阻止并可能逆转病理过程。
