Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine

Haruki Funao, Masaya Nakamura, Naobumi Hosogane, Kota Watanabe, Takashi Tsuji, Ken Ishii, Michihiro Kamata, Yoshiaki Toyama, Kazuhiro Chiba, Morio Matsumoto

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

BACKGROUND: Because an idiopathic spinal extradural arachnoid cyst (SEAC) is rare, its optimal surgical treatment remains controversial. OBJECTIVE: To evaluate the results of surgical treatments for SEACs and to clarify features of the disease associated with poor outcomes. METHODS: Twelve patients with SEACs who underwent surgery at our hospital between 1988 and 2008 were examined retrospectively. The mean follow-up period was 4.7 years. Total resection of the cyst was performed in 7 patients and closure of the dural defect without cyst resection in 5 patients. Surgical outcomes were evaluated with regard to the duration of symptoms, the size of the cyst, and the surgical procedure used. RESULTS: Neurological recovery was observed in all patients, and there was no recurrence. Poor outcomes were observed in patients with a long duration of symptoms (>1 year, P < .01) and large cyst size (>5 vertebrae, P < .05). The surgical procedure had no significant association with the postoperative neurological recovery. However, there was a significant difference in the degree of the mean postoperative kyphotic angle between the patients treated by total resection of the cyst (9.7 degrees) and those treated by closure of the dural defect without cyst resection through selective laminectomy (2.2 degrees) (P < .01). CONCLUSION: There was no significant difference in postoperative neurological recovery between the 2 surgical procedures. However, closure of the dural defect without cyst resection was less invasive, preventing postoperative kyphotic deformity of the thoracolumbar spine.

Original languageEnglish
Pages (from-to)278-284
Number of pages7
JournalNeurosurgery
Volume71
Issue number2
DOIs
Publication statusPublished - 01-08-2012

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Arachnoid Cysts
Cysts
Spine
Therapeutics
Laminectomy
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Funao, H., Nakamura, M., Hosogane, N., Watanabe, K., Tsuji, T., Ishii, K., ... Matsumoto, M. (2012). Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine. Neurosurgery, 71(2), 278-284. https://doi.org/10.1227/NEU.0b013e318257bf74
Funao, Haruki ; Nakamura, Masaya ; Hosogane, Naobumi ; Watanabe, Kota ; Tsuji, Takashi ; Ishii, Ken ; Kamata, Michihiro ; Toyama, Yoshiaki ; Chiba, Kazuhiro ; Matsumoto, Morio. / Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine. In: Neurosurgery. 2012 ; Vol. 71, No. 2. pp. 278-284.
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Funao, H, Nakamura, M, Hosogane, N, Watanabe, K, Tsuji, T, Ishii, K, Kamata, M, Toyama, Y, Chiba, K & Matsumoto, M 2012, 'Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine', Neurosurgery, vol. 71, no. 2, pp. 278-284. https://doi.org/10.1227/NEU.0b013e318257bf74

Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine. / Funao, Haruki; Nakamura, Masaya; Hosogane, Naobumi; Watanabe, Kota; Tsuji, Takashi; Ishii, Ken; Kamata, Michihiro; Toyama, Yoshiaki; Chiba, Kazuhiro; Matsumoto, Morio.

In: Neurosurgery, Vol. 71, No. 2, 01.08.2012, p. 278-284.

Research output: Contribution to journalArticle

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T1 - Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine

AU - Funao, Haruki

AU - Nakamura, Masaya

AU - Hosogane, Naobumi

AU - Watanabe, Kota

AU - Tsuji, Takashi

AU - Ishii, Ken

AU - Kamata, Michihiro

AU - Toyama, Yoshiaki

AU - Chiba, Kazuhiro

AU - Matsumoto, Morio

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N2 - BACKGROUND: Because an idiopathic spinal extradural arachnoid cyst (SEAC) is rare, its optimal surgical treatment remains controversial. OBJECTIVE: To evaluate the results of surgical treatments for SEACs and to clarify features of the disease associated with poor outcomes. METHODS: Twelve patients with SEACs who underwent surgery at our hospital between 1988 and 2008 were examined retrospectively. The mean follow-up period was 4.7 years. Total resection of the cyst was performed in 7 patients and closure of the dural defect without cyst resection in 5 patients. Surgical outcomes were evaluated with regard to the duration of symptoms, the size of the cyst, and the surgical procedure used. RESULTS: Neurological recovery was observed in all patients, and there was no recurrence. Poor outcomes were observed in patients with a long duration of symptoms (>1 year, P < .01) and large cyst size (>5 vertebrae, P < .05). The surgical procedure had no significant association with the postoperative neurological recovery. However, there was a significant difference in the degree of the mean postoperative kyphotic angle between the patients treated by total resection of the cyst (9.7 degrees) and those treated by closure of the dural defect without cyst resection through selective laminectomy (2.2 degrees) (P < .01). CONCLUSION: There was no significant difference in postoperative neurological recovery between the 2 surgical procedures. However, closure of the dural defect without cyst resection was less invasive, preventing postoperative kyphotic deformity of the thoracolumbar spine.

AB - BACKGROUND: Because an idiopathic spinal extradural arachnoid cyst (SEAC) is rare, its optimal surgical treatment remains controversial. OBJECTIVE: To evaluate the results of surgical treatments for SEACs and to clarify features of the disease associated with poor outcomes. METHODS: Twelve patients with SEACs who underwent surgery at our hospital between 1988 and 2008 were examined retrospectively. The mean follow-up period was 4.7 years. Total resection of the cyst was performed in 7 patients and closure of the dural defect without cyst resection in 5 patients. Surgical outcomes were evaluated with regard to the duration of symptoms, the size of the cyst, and the surgical procedure used. RESULTS: Neurological recovery was observed in all patients, and there was no recurrence. Poor outcomes were observed in patients with a long duration of symptoms (>1 year, P < .01) and large cyst size (>5 vertebrae, P < .05). The surgical procedure had no significant association with the postoperative neurological recovery. However, there was a significant difference in the degree of the mean postoperative kyphotic angle between the patients treated by total resection of the cyst (9.7 degrees) and those treated by closure of the dural defect without cyst resection through selective laminectomy (2.2 degrees) (P < .01). CONCLUSION: There was no significant difference in postoperative neurological recovery between the 2 surgical procedures. However, closure of the dural defect without cyst resection was less invasive, preventing postoperative kyphotic deformity of the thoracolumbar spine.

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