Horak Victoria Jane, Jimenez Med Jimson D, LoPresti Melissa A, Raskin Jeffrey S
1Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois.
2Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois; and.
J Neurosurg Case Lessons. 2023 Aug 7;6(6). doi: 10.3171/CASE23217.
Intradural spinal arachnoid cysts (SACs) are a rare cause of spinal cord compression. Treatment is centered on decompression of the spinal cord via laminectomy or laminoplasty followed by resection or fenestration of the cyst. Although laminectomy or laminoplasty access may be needed to achieve the desired result, either procedure can be associated with more extensive surgical dissections and long-term spinal stability concerns, including postsurgical kyphosis.
The authors present a case of a cervical intradural SAC in a 4-month-old girl presenting with symptomatic compression. The patient was treated by laminotomy and endoscopic fenestration of the SAC with resolution of symptoms and no disease progression 10 months postoperatively, when the patient was 14 months old.
Microsurgical endoscopic fenestration of an intradural SAC can provide a less invasive means of treatment while avoiding the risks associated with more invasive approaches.
硬脊膜内脊髓蛛网膜囊肿（SACs）是脊髓压迫的罕见原因。治疗的核心是通过椎板切除术或椎板成形术对脊髓进行减压，随后切除囊肿或进行囊肿开窗术。尽管可能需要通过椎板切除术或椎板成形术来达到预期效果，但这两种手术都可能涉及更广泛的手术解剖，并且存在长期脊柱稳定性问题，包括术后脊柱后凸。
作者报告了一例4个月大女童的颈段硬脊膜内SAC病例，该患儿出现了有症状的压迫。患者接受了椎板切开术和SAC的内镜开窗术治疗，术后10个月（患者14个月大时）症状缓解且无疾病进展。
硬脊膜内SAC的显微外科内镜开窗术可以提供一种侵入性较小的治疗方法，同时避免与侵入性更强的方法相关的风险。
