Surgical treatment of epidural arachnoid cyst type II of the thoracic and lumbar spine: case report

Abstract

Background. Spinal epidural arachnoid cysts are the protrusion of the arachnoid membrane through an existing defect in the dural, functioning as a valve. Literature data on diagnosis and surgical treatment are presented by descriptions of clinical cases and there is no consensus on the optimal approach to solving this problem.Aim. To present a clinical case of surgical treatment of epidural arachnoid cyst type II of the thoracic and lumbar spine; to analyze methods of diagnosis and surgical treatment of such cysts.Materials and methods. All cases of diagnosis and treatment of spinal epidural arachnoid cysts in adults published in the PubMed search engine by 2021 have been analyzed. A clinical case of successful surgical treatment of an epidural arachnoid cyst of the thoracic and lumbar spine of type II on the basis of the Almazov National Medical Research Centre (Saint Petersburg, Russia) is presented.Results. Analysis of the published results of treatment of patients with epidural arachnoid cysts showed that the main task facing the surgeon is to identify and close the communication between the cyst and the subdural space. To accurately determine the localization of the dura mater defect and minimize operative access, many authors consider computed tomography myelography to be effective.Conclusion. Despite the variety of existing diagnostic methods, a specific and accurate way to visualize the defect has not been found to date. Based on the analysis of the literature, it can be said that the rarity of publications on this topic makes even individual reports relevant, and today there is no way to propose a specific strategy for the diagnosis and surgical treatment of such cysts.