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DOI: 10.1055/a-2482-9156
Arachnoid Cyst as a Late Complication of Selective Dorsal Rhizotomy: A Case Report
Abstract
Background and importance Selective dorsal rhizotomy (SDR) is a surgical technique to treat spasticity, mainly in children with spastic cerebral palsy (CP). In this report, a unique case of a late arachnoid cyst, causing radiating pain in the left leg, is presented. This is relevant to clinicians managing the long-term follow-up of patients who underwent selective dorsal rhizotomy (SDR).
Clinical presentation A 25-year-old male with bilateral spastic CP, who underwent SDR at the age of 7, presented with symptoms of progressive radiating pain in the left leg. Magnetic resonance imaging (MRI) revealed the presence of a large arachnoid cyst and a remarkable dorsal position of the cauda equina. After dissection of the cyst, the previously experienced radiating pain immediately subsided; however, the patient developed urinary retention and constipation. Cauda compression was ruled out by MRI. The constipation subsided quickly, and the patient performed self-catheterization until 1 month postoperatively for the urinary retention after which there were no signs of ongoing bladder dysfunction.
Conclusion Arachnoid cyst formation can be a late complication of SDR and can cause lumbosacral radicular syndrome in the late postoperative course in select cases.
Disclosures
The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article. The patient provided written informed consent to publish this case and this study has been approved by the non-WMO Committee of the Medical Ethics Review Committee of Amsterdam University Medical Center.
Publikationsverlauf
Eingereicht: 24. August 2024
Angenommen: 11. November 2024
Artikel online veröffentlicht:
23. Dezember 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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References
- 1 Patel DR, Neelakantan M, Pandher K, Merrick J. Cerebral palsy in children: a clinical overview. Transl Pediatr 2020; 9 (Suppl. 01) S125-S135
- 2 Tilton A. Management of spasticity in children with cerebral palsy. Semin Pediatr Neurol 2009; 16 (02) 82-89
- 3 Mishra D, Barik S, Raj V, Kandwal P. A systematic review of complications following selective dorsal rhizotomy in cerebral palsy. Neurochirurgie 2023; 69 (03) 101425
- 4 Langerak NG, Vaughan CL, Hoffman EB, Figaji AA, Fieggen AG, Peter JC. Incidence of spinal abnormalities in patients with spastic diplegia 17 to 26 years after selective dorsal rhizotomy. Childs Nerv Syst 2009; 25 (12) 1593-1603
- 5 Klekamp J. A new classification for pathologies of spinal meninges-part 2: primary and secondary intradural arachnoid cysts. Neurosurgery 2017; 81 (02) 217-229
- 6 Agha RA, Franchi T, Sohrabi C, Mathew G, Kerwan A, Group S. SCARE Group. The SCARE 2020 guideline: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg 2020; 84: 226-230
- 7 Martens mdPEMvS BHM, van Ouwerkerk WJR, Becher JG, Vermeulen RJ, Buizer AI. Selective dorsal rhizotomy as treatment in spastic cerebral palsy. Tijdschr Neurol Neurochir 2018; 119 (04) 123-127
- 8 Wang YB, Wang DH, Deng SL. Symptomatic secondary spinal arachnoid cysts: a systematic review. Spine J 2023; 23 (08) 1199-1211