Imwinkelried Lara, Nasiri Danial, Schär Ralph T, Goldberg Johannes, Häni Levin, Raabe Andreas, Jesse Christopher Marvin
Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Department of Neurosurgery, University Hospital Basel, Basel, Switzerland.
Acta Neurochir (Wien). 2025 Sep 19;167(1):248. doi: 10.1007/s00701-025-06665-7.
Spinal arachnoid cysts (SAC) and spinal arachnoid webs (SAW) are intradural pathologies, often presenting with pain and/or myelopathic symptoms. Reports on postoperative outcomes for SAC and SAW are scarce. This study aims to assess the surgical outcomes of SAC and SAW.
Patients who underwent surgical treatment for SAC or SAW at our institution between 2011 and 2023 were retrospectively reviewed. Demographic data, radiological findings, surgical management, and clinical outcomes were evaluated using the modified McCormick (mMC) scale. Outcomes were categorized as "favorable" (mMC I-II) or "unfavorable" (mMC III-V).
A total of 35 patients (29 SAC, 6 SAW) were analyzed. Mean age was 50.9 (SD ± 9.8) years. Males comprised 70.3% of cases (SAC: 64.5%, SAW: 100%). Most common symptoms were local or radiating pain (SAC 77.4%; SAW 100%), gait-disturbance (SAC 45.2%; SAW 16.7%), sensory-deficits (SAC 32.3%; SAW 66.7%) and impaired motor function (SAC 20%; SAW 16.7%). Median preoperative mMC was 2 in both groups (SAC IQR: 1; SAW IQR: 1). Median postoperative mMC was 1 in both groups (SAC CI 1.07-1.34; SAW CI 0.74-1.60). Favorable outcome (postoperative mMC I-II) was achieved in 26 SAC patients (90%) and 5 SAW patients (83%) respectively. Surgical complications occurred in 14.7%, all in the SAC group, without lasting deficits.
Surgical treatment for SAC and SAW appears to have an overall favorable outcome, though larger cohort analyses are needed. Surgery should be considered in symptomatic patients.
脊髓蛛网膜囊肿（SAC）和脊髓蛛网膜网（SAW）是硬脊膜内病变，常表现为疼痛和/或脊髓病症状。关于SAC和SAW术后结果的报道较少。本研究旨在评估SAC和SAW的手术效果。
回顾性分析2011年至2023年在我院接受SAC或SAW手术治疗的患者。使用改良的麦考密克（mMC）量表评估人口统计学数据、影像学表现、手术管理和临床结果。结果分为“良好”（mMC I-II）或“不佳”（mMC III-V）。
共分析了35例患者（29例SAC，6例SAW）。平均年龄为50.9（标准差±9.8）岁。男性占病例的70.3%（SAC：64.5%，SAW：100%）。最常见的症状是局部或放射性疼痛（SAC 77.4%；SAW 100%）、步态障碍（SAC 45.2%；SAW 16.7%）、感觉缺陷（SAC 32.3%；SAW 66.7%）和运动功能受损（SAC 20%；SAW 16.7%）。两组术前mMC中位数均为2（SAC四分位间距：1；SAW四分位间距：1）。两组术后mMC中位数均为1（SAC可信区间1.07-1.34；SAW可信区间0.74-1.60）。26例SAC患者（90%）和5例SAW患者（83%）分别获得了良好的结果（术后mMC I-II）。手术并发症发生率为14.7%，均发生在SAC组，无持久性功能缺损。
SAC和SAW的手术治疗总体效果似乎良好，不过需要进行更大规模的队列分析。有症状的患者应考虑手术治疗。
