Abstract
Objective To summarize the clinical manifestation,imaging characteristic and experience of surgical treatment of extradural meningeal cyst at thoraco - lumbar spine.Methods The authors retrospectively analyzed a series of 10 patients with extradural meningeal cyst at thoraco - lumbar spine surgically treated under microscope from 2001to 2011.There were 4 males and 6 fameles with average age of 26.5 yaers ( rang from 7 to 54 years old ).The weakness of lower extremities,bowl and bladder dysfunction were the main clinical manifestation.MRI inmaging showed the cyst located dorsal to the spinal cord and extending to the neural formen with lower signal in T1and higher signal in T2 seriers without enhancement.The lesions located at thoraco - lumbar spine range from T10 and L3.10 operations had been performed with the cyst resection and fistula repairment under microscope. The patients remained prone position until 7 days post - operition.Results The meningeal cyst had been gross total or subtotal resected and histological examination showed typical meningeal cyst tissue in all cases. There was no operative complication happened.The lower limbs weakness or bowel and bladder dysfunction were gradually relieved post-operation.The period of follow- up was ranged from 3 months to 10 years (average 4.1years).All the patients with neurological intact,there were no recurrence of the cyst and the alignment and lordosis of spine were kept evaluated with MRI investigation during follow - up period.Conclusions The extradural meningeal cyst at thoraco - lumbar spine are rare found and characterized by chronic decompression of spinal cord and nerve,the manifestation in MRI imaging is cystolic CSF signal both in T1and T2 series without enhancement.The surgical treatment including dissection of the wall of the cyst,find and repair the CSF leakage under microscope,the outcome of surgical treatment is satisfactory. Key words: Spine; Microsurgery; Meningeal cyst
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