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. 2009 Jul 13;21(9):427–432. doi: 10.1016/S1607-551X(09)70146-9

Huge Spinal Extradural Meningeal Cyst in the Thoracolumbar Spine: A Case Report of a Rare Cause of Low Back Pain

Su‐Hao Liu 1, Jih‐Tsun Ho 1, Chi‐Man Yip 1, Wei‐Chuan Liao 1, Shu‐Shong Hsu 1,✉, Ping‐Hong Lai 1,2, Hui‐Hwa Tseng 1,3
PMCID: PMC11917668  PMID: 16248128

Abstract

Symptomatic intraspinal extradural meningeal cysts are rare. We present the case of a 17‐year‐old female with low back pain, progressive numbness, and radiation pain to the flank and lower limbs. Magnetic resonance imaging and computed tomographic myelography revealed a huge intraspinal extradural meningeal cyst extending from T12 to L3 with cord and dural sac compression. The patient underwent surgery to open the cyst and close the connecting dural defect. Pathologic examination of the cyst disclosed non‐specific fibrous connective tissue without an inner arachnoid single‐cell lining. She achieved complete recovery after the operation. There was no recurrence of the cyst at a 2‐year follow‐up.

Keywords: spinal cyst, extradural cyst, meningeal cyst, arachnoid cyst, spinal cord compression

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References

  • 1. Dastur HM. The radiological appearances of spinal extradural arachnoid cysts. J Neurol Neurosurg Psychiatry. 1963; 26: 231–235. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2. McCrum C, Williams B. Spinal extradural arachnoid pouches. Report of two cases. J Neurosurg. 1982; 57: 849–852. [DOI] [PubMed] [Google Scholar]
  • 3. Chan RC, Thompson GB, Bratty PJA. Symptomatic anterior spinal arachnoid diverticulum. Neurosurgery. 1985; 16: 663–665. [DOI] [PubMed] [Google Scholar]
  • 4. Tarlov IM. Spinal perineural and meningeal cysts. J Neurol Neurosurg Psychiatry. 1970; 33: 833–843. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5. Joseph RA, McKenzie T. Occult intrasacral meningocele. J Neurol Neurosurg Psychiatry. 1970; 33: 493–496. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6. Nabors MW, Pait TG, Byrd EB, et al. Updated assessment and current classification of spinal meningeal cysts. J Neurosurg. 1988; 68: 366–377. [DOI] [PubMed] [Google Scholar]
  • 7. Fortuna A, La Torre E, Ciappetta P. Arachnoid diverticula: a unitary approach to spinal cysts communicating with the subarachnoid space. Acta Neurochir. 1977; 39: 259–268. [DOI] [PubMed] [Google Scholar]
  • 8. Cloward RB. Congenital spinal extradural cysts: case report with review of literature. Ann Surg. 1968; 168: 851–864. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9. Kendall BE, Valentine AR, Keis B. Spinal arachnoid cysts: clinical and radiological correlation with prognosis. Neuroradiology. 1982; 22: 225–234. [DOI] [PubMed] [Google Scholar]
  • 10. Elsberg CA, Dyke CG, Brewer ED. The symptoms and diagnosis of extradural cysts. Bull Neurol Inst NY. 1934; 3: 395–417. [Google Scholar]
  • 11. Rohrer DC, Burchiel KJ, Gruber DP. Intraspinal extradural meningeal cyst demonstrating ball‐valve mechanism of formation. Case report. J Neurosurg. 1993; 78: 122–125. [DOI] [PubMed] [Google Scholar]
  • 12. Nugent GR, Odom GL, Woodhall B. Spinal extradural cysts. Neurology. 1959; 9: 397–406. [DOI] [PubMed] [Google Scholar]
  • 13. Bregland RM. Congenital intraspinal extradural cyst. Report of three cases in one family. J Neurosurg. 1968; 28: 495–499. [DOI] [PubMed] [Google Scholar]
  • 14. Robinow M, Johnson GF, Verhagen AD. Distichiasislymphedema. A hereditary syndrome of multiple congenital defects. Am J Dis Child. 1970; 119: 343–347. [PubMed] [Google Scholar]
  • 15. Schwartz JF, O'Brien MS, Hoffman JC Jr. Hereditary spinal arachnoid cysts, distichiasis, and lymphedema. Ann Neurol. 1980; 7: 340–343. [DOI] [PubMed] [Google Scholar]
  • 16. Rex BA, Wennström KG. Arachnoidal proliferation and cystic formation in the spinal nerve‐root pouches of man. J Neurosurg. 1959; 16: 73–84. [DOI] [PubMed] [Google Scholar]
  • 17. Gortvai P. Extradural cysts of the spinal canal. J Neurol Neurosurg Psychiatry. 1963; 26: 223–230. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18. Cheng MH. Intraspinal extradural arachnoid cyst with spinal cord herniation. J Formos Med Assoc. 1996; 95: 712–714. [PubMed] [Google Scholar]
  • 19. Chen CJ, Ro LS. The MRI signs of spinal arachnoid diverticula. Neuroradiology. 1997; 39: 446–449. [DOI] [PubMed] [Google Scholar]
  • 20. Hald JK, Bakke SJ, Nakstad PH, et al. Magnetic resonance imaging of an epidural spinal arachnoid cyst. Acta Radiol. 1989; 30: 491–493. [PubMed] [Google Scholar]
  • 21. Rimmelin A, Clouet PL, Salatino S, et al. Imaging of thoracic and lumbar spinal extradural arachnoid cysts: report of two cases. Neuroradiology. 1997; 39: 203–206. [DOI] [PubMed] [Google Scholar]
  • 22. Van de Kelft E, Van Vyve M. Chronic perineal pain related to sacral meningeal cysts. Neurosurgery. 1991; 29: 223–226. [DOI] [PubMed] [Google Scholar]
  • 23. Kunz U, Mauer UM, Waldbaur H. Lumbosacral extradural arachnoid cysts: diagnostic and indication for surgery. Eur Spine J. 1999; 8: 218–222. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24. Muthukumar N. Sacral extradural arachnoid cyst: a rare cause of low back and perineal pain. Eur Spine J. 2002; 11: 162–166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25. Sato K, Nagata K, Sugita Y. Spinal extradural meningeal cyst: correct radiological and histopathological diagnosis. Neurosurg Focus. 2002; 13: 1. [DOI] [PubMed] [Google Scholar]
  • 26. Kim CH, Bak KH, Kim JM, et al. Symptomatic sacral extradural arachnoid cyst associated with lumbar intradural arachnoid cyst. Clin Neurol Neurosurg. 1999; 101: 148–152. [DOI] [PubMed] [Google Scholar]
  • 27. Burger PC, Scheithauer BW, Vogel FS. Surgical Pathology of the Nervous System and its Coverings. 3rd edition. New York: Churchill Livingstone. 1991, 616–620. [Google Scholar]
  • 28. Khosla A, Wippold FJ. CT myelography and MR imaging of extramedullary cysts of the spinal canal in adult and pediatric patients. AJR Am J Roentgenol. 2002; 178: 201–207. [DOI] [PubMed] [Google Scholar]
  • 29. Mongia S, Devi BI, Shaji KR, Hegde T. Spinal subdural epidermoids – a separate entity: case report of 3 cases. Neurol India. 2002; 50: 529–530. [PubMed] [Google Scholar]
  • 30. Robertson DP, Kirkpatrick IB, Harper RL, et al. Spinal intramedullary ependymal cyst: report of three cases. J Neurosurg. 1991; 75: 312–316. [DOI] [PubMed] [Google Scholar]
  • 31. Hatashita S, Kondo A, Shimizu T, et al. Spinal extradural arachnoid cyst: case report. Neurol Med Chir (Tokyo). 2001; 41: 318–321. [DOI] [PubMed] [Google Scholar]
  • 32. Ido K, Matsuoka H, Urushidani H. Effectiveness of a transforaminal surgical procedure for spinal extradural arachnoid cyst in the upper lumbar spine. J Clin Neurosci. 2002; 9: 694–696. [DOI] [PubMed] [Google Scholar]
  • 33. Carrillo R. Lumbar cerebrospinal fluid drainage for symptomatic sacral nerve root cysts: an adjuvant diagnostic procedure and/or alternative treatment? Technical case report. Neurosurgery. 1998; 42: 952–953. [DOI] [PubMed] [Google Scholar]

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