Objective To evaluate the clinical efficacy of incising spinal pia mater to relieve pressure and unilateral open-door laminoplasty with internal screw fixation for treatment of the dated spinal cord injury. Methods Fr...Objective To evaluate the clinical efficacy of incising spinal pia mater to relieve pressure and unilateral open-door laminoplasty with internal screw fixation for treatment of the dated spinal cord injury. Methods From March, 2009 to July, 2010, 16 cases with chronic cervical cord injury underwent spinal dura mater incision and unilateral open-door laminoplasty with internal screw fixation. Nerve functions of preand postoperation were evaluated by Frankel classification and the Japanese Orthopaedic Association (JOA) scale. The improvement rate of JOA score at the indicated time was recorded. Results Postoperative Frankel classification rating of 16 patients improved obviously. JOA scores at the 1st month, 3rd month, 6th month, and 12th month after surgery were 7.9±2.3, 8.5±1.6, 8.9±2.1, and 12.4±2.5, respectively, and significantly increased compared with that prior to surgery (5.5±0.6). At the end of follow-up period, JOA score was significantly higher than that of pre-treatment (P<0.05). The recovery was relatively rapid during the first 3 months following the surgery, then entered a platform period. Conclusion It is effective for patients with dated spinal cord injury to undergo spinal decompression and laminoplasty.展开更多
BACKGROUND Posterior atlantoaxial dislocation(PAD)is a rare type of upper cervical spine disease.We sought to describe a unreported case of old PAD with os odontoideum(OO)and atlas hypoplasia(AH)and our unique treatme...BACKGROUND Posterior atlantoaxial dislocation(PAD)is a rare type of upper cervical spine disease.We sought to describe a unreported case of old PAD with os odontoideum(OO)and atlas hypoplasia(AH)and our unique treatment approach consisting of C1 single door laminoplasty with C1-3 posterior fixation and fusion.CASE SUMMARY A 70-year-old male patient who suffered from progressive aggravating numbness and limb weakness for 4 years without trauma,was diagnosed with old PAD with OO and AH.The patient underwent closed reduction and C1 single door laminoplasty with C1-3 posterior fixation and fusion instead of C1 laminectomy with occipitocervical fusion.During the 3-year follow-up,he was able to walk by himself instead of using a wheelchair and with a±25°range of head rotation as well as a±10°range of flexion-extension.Three-year follow-up images showed satisfactory reduction and fusion.CONCLUSION C1 single door laminoplasty with cervical fusion in PAD combined with spinal cord compression could be a suitable and effective surgical option.Compared with laminectomy and occipitocervical fusion,it retains more cervical range of motion,has a smaller incision and provides an adequate bone grafting space for atlantoaxial fusion.展开更多
Auricular acupuncture combined with local anaesthesia in cervical larninoplasty was studied. The aim of the study was to observe the analgesic action of this anaesthesia and the effects on respiratory and circulatory ...Auricular acupuncture combined with local anaesthesia in cervical larninoplasty was studied. The aim of the study was to observe the analgesic action of this anaesthesia and the effects on respiratory and circulatory function. 70 patients were included in the study. There were 55 male and 15 female patients, aged between 39 and 67 years old. The unilateral otopoints including Shenmen, cervical vertebrae, sympathetic, subcortex, external lung and kidney points were used. The sterilized filiform needle of 1 - 1. 5 cm were inserted into each otopoint and connected to 57 - 6 electrcrpulse stimulator being stimulated with continuous wave. Local infiltration anaesthesia was also used with 1 - 2 g/L Lignocaine. The results showed that all the patients were conscious, quiet and co-operative with doctors.The respiration, blood pressure and heart rate were all stable. Analgesie action was rather definite. All the patients recovered quickly after operation. We consider that this anaesthesia is a very simple and effective method for cervical laminoplasty.展开更多
BACKGROUND Hydrocephalus following dural tear after spinal surgery is rare.Although a few cases of obstructive hydrocephalus caused by subdural fluid collection and communicating hydrocephalus associated with meningit...BACKGROUND Hydrocephalus following dural tear after spinal surgery is rare.Although a few cases of obstructive hydrocephalus caused by subdural fluid collection and communicating hydrocephalus associated with meningitis have been reported,the mechanism remains uncertain.Herein we describe a patient complicated with hydrocephalus after cervical laminoplasty in whom subdural fluid collection in the cervical spine and posterior cranial fossa rather than chronic meningitis was the main mechanism.CASE SUMMARY A 45-year-old man underwent cervical laminoplasty for cervical spondylotic myelopathy at a local hospital.Ten days postoperatively,a high fever occurred and magnetic resonance imaging(MRI)showed cerebrospinal fluid(CSF)leakage.Pseudomeningocele liquid test showed high levels of protein and white blood cell(WBC)count with negative bacterial culture.The patient was treated with shortterm intravenous antibiotic and discharged with normal body temperature.The patient was uneventful during the first 8 mo follow-up although repeated MRI showed persistent pseudomeningocele.At the 9th mo postoperatively,the patient gradually presented with dizziness and headache accompanied by recurrent weakness of his left arm.Imaging examinations demonstrated hydrocephalus and a cystic lesion around the cervical spinal cord.CSF test from lumbar puncture indicated chronic meningitis.MRI on 1 d after pseudomeningocele drainage showed a significant decrease in the cystic volume,suggesting that the cystic lesion would be subdural fluid collection rather than adhesive arachnoiditis.After dural defect repair,the patient’s symptoms completely resolved and hydrocephalus gradually disappeared.CSF analysis at the 21-mo follow-up revealed significantly decreased protein level and WBC count.CONCLUSION Subdural fluid collection rather than meningitis contributes to the hydrocephalus formation after cervical laminoplasty.展开更多
Cervical laminoplasty surgery is an alternative to laminectomy. It can increase the space of the spinal cord available by raising the lamina, and achieve the indirect decompression effect to treat cervical spondylosis...Cervical laminoplasty surgery is an alternative to laminectomy. It can increase the space of the spinal cord available by raising the lamina, and achieve the indirect decompression effect to treat cervical spondylosis. Various techniques of laminoplasty have since been developed after two prototype techniques: Hirabayashi's open-door laminoplasty and Kurokawa's double-door laminoplasty. Several studies report superior biomechanical stability of the cervical spine after laminoplasty compared with laminectomy. Recent development in laminoplasty is preservation of muscle attachment, which enabled dynamic and static stabilization of the cervical spine by neck extensor muscles. After treatment with new laminoplasty techniques with active postoperative neck muscle exercises, postoperative instability, kyphosis, axial neck pain, and loss of ROM become minimal. The development,complications and future trends of cervical laminoplasty are summarized below.展开更多
The expansive open-door laminoplasty （EOLP） has been proven effective in treating patients with cervical myelopathy caused by bony cervical stenosis or ossification of the posterior longitudinal ligament. The aim of...The expansive open-door laminoplasty （EOLP） has been proven effective in treating patients with cervical myelopathy caused by bony cervical stenosis or ossification of the posterior longitudinal ligament. The aim of the EOLP was to help patients gain neurological improvement by decompressing the spinal cord and nerve root.展开更多
Backgrounds:Cervical posterior decompression surgery is used to relieve ventral compression indirectly by incorporating a backward shift of the spinal cord, and this indirect decompression is bound to be limited. This...Backgrounds:Cervical posterior decompression surgery is used to relieve ventral compression indirectly by incorporating a backward shift of the spinal cord, and this indirect decompression is bound to be limited. This study aimed to determine the decompression limit of posterior surgery and the effect of the decompression range.Methods:We retrospectively reviewed the data of 129 patients who underwent cervical open-door laminoplasty through 2008 to 2012 and were grouped as follows: C4-C7 ( n = 11), C3-C6 ( n = 61), C3-C7 ( n = 32), and C2-C7 ( n = 25). According to the relative location of spinal levels within a decompression range, the type of decompression at a given level was categorized as external decompression (ED;achieved at the levels located immediately external to the decompression range margin), internal decompression (ID;achieved at the levels located immediately internal to the decompression range margin), and central decompression (CD;achieved at the levels located in the center, far from the decompression range margin). The vertebral-cord distance (VCD) was used to evaluate the decompression limit. The C2-C7 angle and VCD on post-operative magnetic resonance images were analyzed and compared between groups. The relationship between VCD and decompression type was analyzed. Moreover, the relationship between the magnitude of the ventral compressive factor and the probability of post-operative residual compression at each level for different decompression ranges was studied. Results:There was no significant kyphosis in cervical curvature (>-5°), and there was no significant difference among the groups ( F = 2.091, P = 0.105). The VCD of a specific level depended on the decompression type of the level and followed this pattern: ED < ID < CD ( P < 0.05). The decompression type of a level was sometimes affected by the decompression range. For a given magnitude of the ventral compressive factor, the probability of residual compression was lower for the group with the larger VCD at this level. Conclusions:Our study suggests that the decompression range affected the decompression limit by changing the decompression type of a particular level. For a given cervical spinal level, the decompression limit significantly varied with decompression type as follows: ED < ID < CD. CD provided maximal decompression limit for a given level. A reasonable range of decompression could be determined based on the relationship between the magnitude of the ventral compressive factor and the decompression limits achieved by different decompression ranges.展开更多
Background：Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy （CSM）.Each posterior technique has its own advantages and disadvantages.In the present study,we co...Background：Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy （CSM）.Each posterior technique has its own advantages and disadvantages.In the present study,we compared the functional and radiological outcomes of expansive hemilaminectomy and laminoplasty with mini titanium plate in the treatment of multilevel CSM.Methods：Forty-four patients with multilevel CSM treated with posterior cervical surgery in Department of Orthopedic Surgery,Beijing Army General Hospital from March 2011 to June 2012 were enrolled in this retrospective study.Patients were divided into two groups by surgical procedure：Laminoplasty （Group L） and hemilaminectomy （Group H）.Perioperative parameters including age,sex,duration of symptoms,opcrative duration,and intraoperative blood loss were recorded and compared.Spinal canal area,calculated using AutoCAD software（Autodesk Inc.,San Rafael,CA,USA）,and neurological improvement,evaluated with Japanese Orthopedic Association score,were also compared.Results：Neurological improvement did not differ significantly between groups.Group H had a significantly shorter operative duration and significantly less blood loss.Mean expansion ratio was significantly greater in Group L （77.83 ± 6.41%） than in Group H （62.72 ± 3.86%） （P 〈 0.01）.Conclusions：Both surgical approaches are safe and effective in treating multilevel CSM.Laminoplasty provides a greater degree of enlargement of the spinal canal,whereas expansive hemilaminectomy has the advantages of shorter operative duration and less intraoperative blood loss.展开更多
Background:The optimal surgical approach for four-level cervical spondylotic myelopathy remains controversial.The purpose of this study was to compare clinical and radiological outcomes and complications between the a...Background:The optimal surgical approach for four-level cervical spondylotic myelopathy remains controversial.The purpose of this study was to compare clinical and radiological outcomes and complications between the anterior and posterior approaches for four-level cervical spondylotic myelopathy.Methods:A total of 19 patients underwent anterior decompression and fusion and 25 patients underwent posterior laminoplasty and instrumentation in this study.Perioperative information,intraoperative blood loss,clinical and radiological outcomes,and complications were recorded.Japanese Orthopedic Association(JOA)score,36-item short form survey(SF-36)score and cervical alignment were assessed.Results:There were no significant differences in JOA scores between the anterior and posterior group preoperatively(11.6±1.6 vs.12.1±1.5),immediately postoperatively(14.4±1.1 vs.13.8±1.3),or at the last follow-up(14.6±1.0 vs.14.2±1.1)(P>0.05).The JOA scores significantly improved immediately postoperatively and at the last follow-up in both groups compared with their preoperative values.The recovery rate was significantly higher in the anterior group both immediately postoperatively and at the last follow-up.The SF-36 score was significantly higher in the anterior group at the last follow-up compared with the preoperative value(69.4 vs.61.7).Imaging revealed that there was no significant difference in the Cobb angle at C2-C7 between the two groups preoperatively(-2.0°±7.3°vs.-1.4°±7.5°).The Cobb angle significantly improved immediately postoperatively(12.3°±4.2°vs.9.2°±3.6°)and at the last follow-up(12.4°±3.5°vs.9.0°±2.6°)in both groups compared with their preoperative values(P=0.00).Three patients had temporary dysphagia in the anterior group and four patients had persistent axial symptoms in the posterior group.Conclusions:Both the anterior and posterior approaches were effective in treating four-level cervical spondylotic myelopathy in terms of neurological clinical outcomes and radiological features.However,the JOA score recovery rate and SF-36 score in the anterior group were significantly higher.Persistent axial pain could be a major concern when undertaking the posterior approach.展开更多
Background:Spinal extradural arachnoid cyst is extremely rare. The longest SEACs that have been reported in previous studies involved no more than 5 spinal segments. This study presents a case of SEAC diagnosed from T...Background:Spinal extradural arachnoid cyst is extremely rare. The longest SEACs that have been reported in previous studies involved no more than 5 spinal segments. This study presents a case of SEAC diagnosed from T9 to L4 and excised through a novel laminectomy/laminoplasty. Case presentation:A 22-year-old female presented with a 5-year history of progressive paraparesis and numbness in both lower limbs. MRI revealed posterolateral epidural cystic mass extending from T9-L4 with a length of 190 mm and width of 15 mm. The cyst was totally removed through surgery. The patient’s symptom was completely relieved 1 year after the surgery. There was no recurrence, compression on the spinal cord, or kyphotic deformity based on MRI and CT taken 1 year after. Conclusion:Spinal extradural arachnoid cysts are relatively uncommon but surgically curable causes of myelopathy. For symptomatic patients, early surgical intervention is suggested for restoring neurological functions. Performing laminectomy by using crainotome is safe and efficient.展开更多
文摘Objective To evaluate the clinical efficacy of incising spinal pia mater to relieve pressure and unilateral open-door laminoplasty with internal screw fixation for treatment of the dated spinal cord injury. Methods From March, 2009 to July, 2010, 16 cases with chronic cervical cord injury underwent spinal dura mater incision and unilateral open-door laminoplasty with internal screw fixation. Nerve functions of preand postoperation were evaluated by Frankel classification and the Japanese Orthopaedic Association (JOA) scale. The improvement rate of JOA score at the indicated time was recorded. Results Postoperative Frankel classification rating of 16 patients improved obviously. JOA scores at the 1st month, 3rd month, 6th month, and 12th month after surgery were 7.9±2.3, 8.5±1.6, 8.9±2.1, and 12.4±2.5, respectively, and significantly increased compared with that prior to surgery (5.5±0.6). At the end of follow-up period, JOA score was significantly higher than that of pre-treatment (P<0.05). The recovery was relatively rapid during the first 3 months following the surgery, then entered a platform period. Conclusion It is effective for patients with dated spinal cord injury to undergo spinal decompression and laminoplasty.
文摘BACKGROUND Posterior atlantoaxial dislocation(PAD)is a rare type of upper cervical spine disease.We sought to describe a unreported case of old PAD with os odontoideum(OO)and atlas hypoplasia(AH)and our unique treatment approach consisting of C1 single door laminoplasty with C1-3 posterior fixation and fusion.CASE SUMMARY A 70-year-old male patient who suffered from progressive aggravating numbness and limb weakness for 4 years without trauma,was diagnosed with old PAD with OO and AH.The patient underwent closed reduction and C1 single door laminoplasty with C1-3 posterior fixation and fusion instead of C1 laminectomy with occipitocervical fusion.During the 3-year follow-up,he was able to walk by himself instead of using a wheelchair and with a±25°range of head rotation as well as a±10°range of flexion-extension.Three-year follow-up images showed satisfactory reduction and fusion.CONCLUSION C1 single door laminoplasty with cervical fusion in PAD combined with spinal cord compression could be a suitable and effective surgical option.Compared with laminectomy and occipitocervical fusion,it retains more cervical range of motion,has a smaller incision and provides an adequate bone grafting space for atlantoaxial fusion.
文摘Auricular acupuncture combined with local anaesthesia in cervical larninoplasty was studied. The aim of the study was to observe the analgesic action of this anaesthesia and the effects on respiratory and circulatory function. 70 patients were included in the study. There were 55 male and 15 female patients, aged between 39 and 67 years old. The unilateral otopoints including Shenmen, cervical vertebrae, sympathetic, subcortex, external lung and kidney points were used. The sterilized filiform needle of 1 - 1. 5 cm were inserted into each otopoint and connected to 57 - 6 electrcrpulse stimulator being stimulated with continuous wave. Local infiltration anaesthesia was also used with 1 - 2 g/L Lignocaine. The results showed that all the patients were conscious, quiet and co-operative with doctors.The respiration, blood pressure and heart rate were all stable. Analgesie action was rather definite. All the patients recovered quickly after operation. We consider that this anaesthesia is a very simple and effective method for cervical laminoplasty.
文摘BACKGROUND Hydrocephalus following dural tear after spinal surgery is rare.Although a few cases of obstructive hydrocephalus caused by subdural fluid collection and communicating hydrocephalus associated with meningitis have been reported,the mechanism remains uncertain.Herein we describe a patient complicated with hydrocephalus after cervical laminoplasty in whom subdural fluid collection in the cervical spine and posterior cranial fossa rather than chronic meningitis was the main mechanism.CASE SUMMARY A 45-year-old man underwent cervical laminoplasty for cervical spondylotic myelopathy at a local hospital.Ten days postoperatively,a high fever occurred and magnetic resonance imaging(MRI)showed cerebrospinal fluid(CSF)leakage.Pseudomeningocele liquid test showed high levels of protein and white blood cell(WBC)count with negative bacterial culture.The patient was treated with shortterm intravenous antibiotic and discharged with normal body temperature.The patient was uneventful during the first 8 mo follow-up although repeated MRI showed persistent pseudomeningocele.At the 9th mo postoperatively,the patient gradually presented with dizziness and headache accompanied by recurrent weakness of his left arm.Imaging examinations demonstrated hydrocephalus and a cystic lesion around the cervical spinal cord.CSF test from lumbar puncture indicated chronic meningitis.MRI on 1 d after pseudomeningocele drainage showed a significant decrease in the cystic volume,suggesting that the cystic lesion would be subdural fluid collection rather than adhesive arachnoiditis.After dural defect repair,the patient’s symptoms completely resolved and hydrocephalus gradually disappeared.CSF analysis at the 21-mo follow-up revealed significantly decreased protein level and WBC count.CONCLUSION Subdural fluid collection rather than meningitis contributes to the hydrocephalus formation after cervical laminoplasty.
基金National Natural Science Foundation of China(81572207).
文摘Cervical laminoplasty surgery is an alternative to laminectomy. It can increase the space of the spinal cord available by raising the lamina, and achieve the indirect decompression effect to treat cervical spondylosis. Various techniques of laminoplasty have since been developed after two prototype techniques: Hirabayashi's open-door laminoplasty and Kurokawa's double-door laminoplasty. Several studies report superior biomechanical stability of the cervical spine after laminoplasty compared with laminectomy. Recent development in laminoplasty is preservation of muscle attachment, which enabled dynamic and static stabilization of the cervical spine by neck extensor muscles. After treatment with new laminoplasty techniques with active postoperative neck muscle exercises, postoperative instability, kyphosis, axial neck pain, and loss of ROM become minimal. The development,complications and future trends of cervical laminoplasty are summarized below.
文摘The expansive open-door laminoplasty （EOLP） has been proven effective in treating patients with cervical myelopathy caused by bony cervical stenosis or ossification of the posterior longitudinal ligament. The aim of the EOLP was to help patients gain neurological improvement by decompressing the spinal cord and nerve root.
文摘Backgrounds:Cervical posterior decompression surgery is used to relieve ventral compression indirectly by incorporating a backward shift of the spinal cord, and this indirect decompression is bound to be limited. This study aimed to determine the decompression limit of posterior surgery and the effect of the decompression range.Methods:We retrospectively reviewed the data of 129 patients who underwent cervical open-door laminoplasty through 2008 to 2012 and were grouped as follows: C4-C7 ( n = 11), C3-C6 ( n = 61), C3-C7 ( n = 32), and C2-C7 ( n = 25). According to the relative location of spinal levels within a decompression range, the type of decompression at a given level was categorized as external decompression (ED;achieved at the levels located immediately external to the decompression range margin), internal decompression (ID;achieved at the levels located immediately internal to the decompression range margin), and central decompression (CD;achieved at the levels located in the center, far from the decompression range margin). The vertebral-cord distance (VCD) was used to evaluate the decompression limit. The C2-C7 angle and VCD on post-operative magnetic resonance images were analyzed and compared between groups. The relationship between VCD and decompression type was analyzed. Moreover, the relationship between the magnitude of the ventral compressive factor and the probability of post-operative residual compression at each level for different decompression ranges was studied. Results:There was no significant kyphosis in cervical curvature (>-5°), and there was no significant difference among the groups ( F = 2.091, P = 0.105). The VCD of a specific level depended on the decompression type of the level and followed this pattern: ED < ID < CD ( P < 0.05). The decompression type of a level was sometimes affected by the decompression range. For a given magnitude of the ventral compressive factor, the probability of residual compression was lower for the group with the larger VCD at this level. Conclusions:Our study suggests that the decompression range affected the decompression limit by changing the decompression type of a particular level. For a given cervical spinal level, the decompression limit significantly varied with decompression type as follows: ED < ID < CD. CD provided maximal decompression limit for a given level. A reasonable range of decompression could be determined based on the relationship between the magnitude of the ventral compressive factor and the decompression limits achieved by different decompression ranges.
文摘Background：Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy （CSM）.Each posterior technique has its own advantages and disadvantages.In the present study,we compared the functional and radiological outcomes of expansive hemilaminectomy and laminoplasty with mini titanium plate in the treatment of multilevel CSM.Methods：Forty-four patients with multilevel CSM treated with posterior cervical surgery in Department of Orthopedic Surgery,Beijing Army General Hospital from March 2011 to June 2012 were enrolled in this retrospective study.Patients were divided into two groups by surgical procedure：Laminoplasty （Group L） and hemilaminectomy （Group H）.Perioperative parameters including age,sex,duration of symptoms,opcrative duration,and intraoperative blood loss were recorded and compared.Spinal canal area,calculated using AutoCAD software（Autodesk Inc.,San Rafael,CA,USA）,and neurological improvement,evaluated with Japanese Orthopedic Association score,were also compared.Results：Neurological improvement did not differ significantly between groups.Group H had a significantly shorter operative duration and significantly less blood loss.Mean expansion ratio was significantly greater in Group L （77.83 ± 6.41%） than in Group H （62.72 ± 3.86%） （P 〈 0.01）.Conclusions：Both surgical approaches are safe and effective in treating multilevel CSM.Laminoplasty provides a greater degree of enlargement of the spinal canal,whereas expansive hemilaminectomy has the advantages of shorter operative duration and less intraoperative blood loss.
文摘Background:The optimal surgical approach for four-level cervical spondylotic myelopathy remains controversial.The purpose of this study was to compare clinical and radiological outcomes and complications between the anterior and posterior approaches for four-level cervical spondylotic myelopathy.Methods:A total of 19 patients underwent anterior decompression and fusion and 25 patients underwent posterior laminoplasty and instrumentation in this study.Perioperative information,intraoperative blood loss,clinical and radiological outcomes,and complications were recorded.Japanese Orthopedic Association(JOA)score,36-item short form survey(SF-36)score and cervical alignment were assessed.Results:There were no significant differences in JOA scores between the anterior and posterior group preoperatively(11.6±1.6 vs.12.1±1.5),immediately postoperatively(14.4±1.1 vs.13.8±1.3),or at the last follow-up(14.6±1.0 vs.14.2±1.1)(P>0.05).The JOA scores significantly improved immediately postoperatively and at the last follow-up in both groups compared with their preoperative values.The recovery rate was significantly higher in the anterior group both immediately postoperatively and at the last follow-up.The SF-36 score was significantly higher in the anterior group at the last follow-up compared with the preoperative value(69.4 vs.61.7).Imaging revealed that there was no significant difference in the Cobb angle at C2-C7 between the two groups preoperatively(-2.0°±7.3°vs.-1.4°±7.5°).The Cobb angle significantly improved immediately postoperatively(12.3°±4.2°vs.9.2°±3.6°)and at the last follow-up(12.4°±3.5°vs.9.0°±2.6°)in both groups compared with their preoperative values(P=0.00).Three patients had temporary dysphagia in the anterior group and four patients had persistent axial symptoms in the posterior group.Conclusions:Both the anterior and posterior approaches were effective in treating four-level cervical spondylotic myelopathy in terms of neurological clinical outcomes and radiological features.However,the JOA score recovery rate and SF-36 score in the anterior group were significantly higher.Persistent axial pain could be a major concern when undertaking the posterior approach.
文摘Background:Spinal extradural arachnoid cyst is extremely rare. The longest SEACs that have been reported in previous studies involved no more than 5 spinal segments. This study presents a case of SEAC diagnosed from T9 to L4 and excised through a novel laminectomy/laminoplasty. Case presentation:A 22-year-old female presented with a 5-year history of progressive paraparesis and numbness in both lower limbs. MRI revealed posterolateral epidural cystic mass extending from T9-L4 with a length of 190 mm and width of 15 mm. The cyst was totally removed through surgery. The patient’s symptom was completely relieved 1 year after the surgery. There was no recurrence, compression on the spinal cord, or kyphotic deformity based on MRI and CT taken 1 year after. Conclusion:Spinal extradural arachnoid cysts are relatively uncommon but surgically curable causes of myelopathy. For symptomatic patients, early surgical intervention is suggested for restoring neurological functions. Performing laminectomy by using crainotome is safe and efficient.
