Abstract
Background and Objective Spinal arachnoid cysts are rare lesions, accounting for only 1% of all primary spinal
mass lesions. They can occur in extradural, intradural, or intramedullary locations.
The extradural cysts are thought to arise from defects in the dura mater through which
the arachnoid herniates. This report presents 10 cases of spinal extradural arachnoid
cysts and discusses our diagnostic and therapeutic approach to this rare clinical
entity.
Patients The archive records of 10 patients with extradural arachnoid cysts who were treated
between 2002 and 2009 were evaluated retrospectively. The study included four male
and six female patients. In nine cases, the lesion was symptomatic; in only one case
was the cyst diagnosed incidentally. Surgical treatment was performed in the nine
symptomatic cases.
Results In nine of these cases, the extradural cysts were solitary; in one case, multiple
extradural cysts were observed. In most of the cases, the lesion was located in the
thoracic region. Total excision of the cyst was achieved for all of the cases treated
surgically except the case with multiple extradural arachnoid cysts. On follow-up
examination, neurologic improvement was observed in all of the surgically treated
patients.
Conclusion Spinal extradural arachnoid cysts are rare pathologies, and treatment options should
be considered carefully. In symptomatic cases, total excision of the cyst should be
considered the gold standard of treatment. We believe that the closure of the dural
defect should be the main surgical goal to prevent recurrence. We propose laminoplasty
for the treatment of extradural arachnoid cysts that involve multiple segments to
prevent postoperative kyphosis.
Keywords
arachnoid cyst - spinal - laminoplasty
