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A Rare Cause of Thoracic Spinal Cord Compression by Multiple Large Tarlov Cysts
Ahmed-Salem Kleib,Sidi-Mohamed Salihy,Hussein Hamdi,Romain Carron,Outouma Soumaré,Ahmed-Salem Kleib 대한신경손상학회 2018 Korean Journal of Neurotrauma Vol.15 No.1
Spinal extradural arachnoid cyst (SEAC) is a rare cause of spinal cord compression. Bifocal location of thoracic and sacralSEACs is rarely reported in the literature. We report a case of thoracic spinal cord compression by SEAC associated withasymptomatic multiple sacral Tarlov cysts (TC). The surgical management and postoperative outcome of the patient arediscussed. A 34-year-old woman was referred to the hospital for acute thoracic pain with a history of chronic long-standing back pain. She complained of walking diffculties. Neurological examination demonstrated incomplete spastic paraplegia with sensory level in T9. Magnetic resonance imaging revealed a large cystic formation from T7-11 and at the levelof the sacrum. We performed laminectomies at the level of interest from T7-11. The cysts were dissected from the underlying dura after removal of the cerebrospinal fluid. We found nerve tissue in the cysts. We excised the cyst and preservedthe nerve roots. Subsequently, a duraplasty was performed with autologous grafts from the lumbar fascia. The conditionof the patient improved after surgery and he was recovering well at follow-up. Although the surgical treatment of TC iscontroversial, especially at the sacral lumbar level, decompression at the dorsal level in this case is indisputable