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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(03): 362-368
DOI: 10.1055/s-0043-1772825
Original Article

Spinal Arachnoid Cysts—Our Experience

Batuk Diyora
1   Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
,
Anup Purandare
1   Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
,
Kavin Devani
1   Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
,
Prakash Palave
1   Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
,
Gagan Dhall
1   Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
,
Sagar Gawali
1   Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
› Author Affiliations Funding None.
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Abstract

Introduction Spinal arachnoid cysts are rare. Most of these lesions are located in the thoracic and thoracolumbar regions. Magnetic resonance imaging is a valuable tool for understanding their location and provides important information regarding their origin and expansion. The aim of our study was to evaluate the demographics, presentations, surgical management, and outcome of a spinal arachnoid cyst.

Materials and Methods All the patients from January 2003 to December 2021 who were symptomatic for spinal arachnoid cysts were taken for study. A retrospective analysis was performed. Radiological investigations were performed, and patients were graded according to the Nabors classification. Operative results were graded according to surgical technique.

Results The study included 22 patients, 11 female and 11 male patients, with a male-to-female ratio of approximately 1:1. The mean age of presentation was 34.7 years (4–60 years). Of 22 patients, 15 have intradural arachnoid cysts, 7 have an intradural extramedullary arachnoid cyst, and 8 have an intramedullary arachnoid cyst. Symptoms varied from weakness in the lower limbs (50%), quadriparesis and spasticity (32%), bladder/bowel incontinence (14%), and pain (10%). Out of 22 patients, complete cyst excision was performed in 17 patients, marsupialization in 4 patients, and cystic-subarachnoid shunt in one patient. Weakness and spasticity gradually recovered over a period of time. At 1-year follow-up, all the patients had complete improvement in their weakness, spasticity, and bladder functions. No recurrence of the cyst was seen at 1-year follow-up.

Conclusion Spinal arachnoid cysts are very rare in the spinal cord. Most of the lesions are located in the thoracic and thoracolumbar regions. Asymptomatic cyst requires counseling and conservative management, whereas symptomatic cyst, if operated on with surgical expertise, recurrence and complications are very low. The best surgical technique for operating these spinal arachnoid cysts is still under question, but symptom improvement is seen in all operative procedures.

Keywords

spine - arachnoid cyst - extradural - intradural - intramedullary

Prior Presentation

Organization: L.T.M. Medical College and Sion General Hospital, Mumbai.




Publication History

Article published online:
25 June 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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