Spinal extradural arachnoid cysts: a rare entity and review of the literature

Abstract

Objective: Spinal extradural arachnoid cysts (SEDC) are rare primary spinal lesions, accounting for less than 1% of all spinal epidural lesions. The literature contains only case reports of this pathology, and treatment remains controversial due to its rarity. Major reported SEDC cases are caused by leaking out of cerebrospinal fluid through a dural defect in the thecal sac forming an extradural cyst. Other reports describe non-communicating SEDC cases where the dural defect was not identified. We report a literature review on SEDC and the case of a 53 year‑old female who presented with type IA extradural cyst with subarachnoid space communication.

Methods: Literature review, preoperative imaging and surgical technique.

Results: The extradural cyst was excised completely and the dural defect was repaired. After surgical decompression, neurological symptoms gradually recovered.

Conclusions: The extradural arachnoid cyst is an uncommon entity. Preoperative imaging is one of the determining elements in orienting the therapeutic management of the SEDCs. The choice of the surgical technique must be the least invasive in order to avoid postoperative complications. Subtotal or complete excision of the cyst, followed by obliteration of the communication stalk and repair of the dural defect is the gold standard treatment.

Keywords: Arachnoid diverticula; Rare entity; SEDC; Spinal extradural arachnoid cyst.