An interdural spinal cyst in the cervicothoracic spine: a review and proposal for a revised classification of spinal meningeal cysts. Illustrative case

Author:

Kawasaki Toshinari1,Takayama Motohiro1,Maki Yoshinori2,Nakajima Kota3,Ioroi Yoshihiko1,Kobayashi Tamaki1

Affiliation:

1. Department of Neurosurgery, Otsu City Hospital, Otsu, Shiga, Japan

2. Department of Rehabilitation, Hikari Hospital, Otsu, Shiga, Japan; and

3. Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan

Abstract

BACKGROUND Spinal cysts in the interdural space are extremely rare and are not included in the standard classification of spinal meningeal cysts. OBSERVATIONS A 60-year-old female presented to our hospital with a spastic gait and numbness in both palms. Magnetic resonance imaging (MRI) revealed a spinal cyst from C4 to T4 compressing the spinal cord. Computed tomography myelography revealed a fistula at C4–5 and C5–6 that connected the cyst along the right C5 and C6 root sleeves. The cyst was located within the dura mater, and communication with the arachnoid space was achieved using a shunt tube. There was partial spastic gait amelioration after the procedure, but the patient experienced a relapse 2 months postoperation. A repeat procedure was performed without a shunt tube to allow greater communication between the cyst and the subarachnoid space. After this, marked improvement in gait function was observed, and MRI showed a significant reduction in cyst volume. LESSONS Interdural spinal meningeal cysts are rare. When the interdural cyst cannot be removed entirely, surgery may be appropriate for providing a shunt tube or establishing communication between the cyst and arachnoid space to maintain the circulation of cerebrospinal fluid collected in the cyst cavity.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

Management Science and Operations Research,Mechanical Engineering,Energy Engineering and Power Technology

Reference8 articles.

1. Updated assessment and current classification of spinal meningeal cysts;Nabors MW,1988

2. Traumatic lumbar interdural cyst with intradural expansion and compression of the cauda equina: case report and surgical video;Aoun SG,2019

3. Traumatic interdural arachnoid cyst in the upper cervical spine. Case report;Chen HJ,1996

4. Interdural cyst of the lumbosacral region;Done SL,1984

5. Symptomatic isolated lumbar interdural arachnoid cyst;Lee JH,2010

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