Acta neurochirurgica
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Acta neurochirurgica · Feb 2012
Thoracolumbar extradural arachnoid cysts: a study of 14 consecutive cases.
To investigate characteristic clinical and radiological features of extradural arachnoid cysts (EDACs) in the thoracolumbar region, a retrospective review of medical records and imaging studies was performed. EDACs are well known but relatively rare lesions in the thoracolumbar spinal canal. The most common site is the lower thoracic spine, and it may cause neurological symptoms by compressing the spinal cord or nerve root. In this study, the pathogenesis, symptomatology, diagnostic approach, and surgical management of EDACs will be discussed. ⋯ Thoracolumbar EDAC patients presented paraparesis and leg pain. Complete excision and closing the communicating point with the subarachnoid space were the choices of treatment, and the outcomes were favorable.
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Acta neurochirurgica · Feb 2012
Posterior C1-2 fusion with C1 lateral mass and C2 isthmic screws: accuracy of screw position, alignment and patient outcome.
Transarticular screw fixation is seen as the "gold standard" in instrumented fusion of C1 and C2. However, drawbacks are the necessity of a reduction before instrumentation and a risk of vertebral artery injury. Therefore, C1 lateral mass and C2 isthmic screws are an alternative. The present study assessed the feasibility of C1-2 stabilization with C1 lateral mass and C2 isthmic screws and evaluated quality of life. ⋯ C1-C2 instrumented fusion with lateral mass and isthmic screws is a safe procedure. Sufficient screw position and alignment was possible in all cases. Therefore, at our institution transarticular screws were abandoned in favor of C1 lateral mass and C2 isthmic screws.