Central Nervous System Neoplasms
The clinical features and surgical outcomes of spinal intramedullary arachnoid cysts
Liu Pengfei, Dong Yang, Sun Jianrui, Pang Changhe
Published 2023-01-28
Cite as Chin J Neurosurg, 2023, 39(1): 41-45. DOI: 10.3760/cma.j.cn112050-20220107-00015
Abstract
ObjectiveTo investigate the clinical characteristics and surgical outcomes of spinal intramedullary arachnoid cysts.
MethodsThe clinical data of 9 patients with spinal intramedullary arachnoid cysts admitted to the Department of Neurosurgery of the First Affiliated Hospital of Zhengzhou University from July 2015 to December 2020 were retrospectively analyzed. All 9 patients underwent cyst decompression and cyst wall resection via dorsomedial approach. The McCormick classification was used to evaluate the spinal cord function of the patients before operation, short-term after operation, and at the final follow-up. During the follow-up period, MRI was re-examined to observe whether the cyst recurred.
ResultsIntramedullary arachnoid cysts in the spinal cord accounted for about 3.86% (9/233) of space-occupying lesions in the spinal cord during the same period. Ages at onset ranged from 10 to 61 years, and the male to female ratio in adults was 2/5. The primary symptoms were mainly bodily pain(6/9) and limb weakness(4/9), sometimes accompanied by an acute course(4/9). Preoperative McCormick grade Ⅰ was revealed in 1 case, Ⅱ in 4 cases, and Ⅲ in 4 cases. Among the 9 patients, most of the cysts were removed in 7 cases, and partial cysts were removed in 2 cases, all of which were confirmed by pathological examination after operation. Postoperative MRI showed that the cysts were significantly shrunk. The symptoms were completely relieved in 4 cases and partially relieved in 5 cases shortly after operation, and the symptoms of 4 cases were further improved during the follow-up period. Except for 1 case lost to follow-up, the follow-up time of the other 8 patients ranged from 12 to 61 months. During the follow-up period, there was no recurrence of symptoms or no enlargement of residual cysts. At the last follow-up, the McCormick grades of the 8 patients were all grade Ⅰ.
ConclusionsIntramedullary arachnoid cysts of the spinal cord are rare clinical entities which are more common in women than in men, and patients with symptoms should be actively treated with surgery, and the clinical prognosis seems good.
Key words:
Arachnoid cyst; Spinal cord; Neurosurgical procedures; Disease attributes; Treatment outcome
Contributor Information
Liu Pengfei
Department of Neurosurgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
Dong Yang
Department of Neurosurgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
Sun Jianrui
Department of Neurosurgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
Pang Changhe
Department of Neurosurgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
