gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Surgical treatment of intradural spinal arachnoid cysts

Chirurgische Behandlung intraduraler spinaler Arachnoidalzysten

Meeting Abstract

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  • corresponding author J. Klekamp - Zentrum Neurochirurgie, Christliches Krankenhaus Quakenbrück

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-12.03

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Veröffentlicht: 4. Mai 2005

© 2005 Klekamp.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.




Intradural spinal arachnoid cysts may be related to trauma or meningeal inflammations and cause slowly progressive but often fluctuating neurological symptoms. They can easily be overlooked even with careful reviews of magnetic resonance images (MRI). This paper will describe the neuroradiological diagnosis, treatment and outcome of spinal cord arachnoid cysts.


Hospital files, neuroradiological examinations, intraoperative documentations and follow-up examinations were analysed. The clinical course was documented with a neurological scoring system for each symptom and the Karnofsky score. Recurrence rates were determined according to Kaplan-Meier statistics.


Between 1977 and 2004, 52 patients presented with an intradural arachnoid cyst of the spinal canal. They presented at an average age of 46±15 years. 42 patients underwent a total of 45 operations after an average history of 64±102 months (range 2 months to 47 years). 10 patients refused surgery or were asymptomatic. Mean follow-up was 28±33 months. Neuroradiological signs on MRI included visible cyst walls, compression or displacement of the spinal cord, or alteration of cerebrospinal fluid (csf) flow on cardiac gated cine-MRI. In doubtful cases, myelography and postmyelographic computer tomography (CT) established the diagnosis. 25 patients demonstrated a syrinx. All patients demonstrated a slowly progressive myelopathy with sometimes fluctuating severity leading to misdiagnosis in a significant number of cases. Surgery consisted of wide fenestration of the cyst wall and a duraplasty to avoid postoperative cord tethering. Complications were observed in 10% of patients with no permanent surgical morbidity. The Karnofsky score increased significantly from 69±14 preoperatively to 75±18 after 1 year. Recurrences were related to arachnoid scar formation and obeserved only within the first postoperative year at a rate of 19%.


Intradural arachnoid cysts of the spinal canal may easily be overlooked on standard MRI examinations. Patients with slowly progressive or fluctuating signs of myelopathy should undergo cardiac gated cine-MRI examinations and myelography once other neurological causes such as inflammatory diseases have been ruled. With careful microsurgical fenestration of the cyst sustained postoperative improvements can be expected with a good long-term prognosis.