Clinical Profile and Treatment Outcome of Spinal Epidural Arachnoid Cysts: A Systematic Review of Case Studies and Reports

Background A spinal epidural arachnoid cyst (SEAC) is a rare clinical entity. We performed a systematic review of the literature to obtain information regarding demographics, clinical presentation, treatment modalities, and outcome of SEACs. Methods A literature search was performed by us...

Full description

Saved in:
Bibliographic Details
Main Authors: Aditya K. Patil, Srikant K. Swain, Suresh Sharma, Rajnish Kumar Arora, Achal Sharma, Poonam Arora, Radhey S. Mittal
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2023-03-01
Series:Indian Journal of Neurosurgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731623
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850110179179233280
author Aditya K. Patil
Srikant K. Swain
Suresh Sharma
Rajnish Kumar Arora
Achal Sharma
Poonam Arora
Radhey S. Mittal
author_facet Aditya K. Patil
Srikant K. Swain
Suresh Sharma
Rajnish Kumar Arora
Achal Sharma
Poonam Arora
Radhey S. Mittal
author_sort Aditya K. Patil
collection DOAJ
description Background A spinal epidural arachnoid cyst (SEAC) is a rare clinical entity. We performed a systematic review of the literature to obtain information regarding demographics, clinical presentation, treatment modalities, and outcome of SEACs. Methods A literature search was performed by using the databases PubMed/Medline, PubMed Central, Embase, Cochrane Library, Ovid MEDLINE, and Ovid Medline In-Process. A total of 170 articles were found on literature search. We found 575 cases of SEAC since 1904 for inclusion in the review including three cases which were operated by us. We studied the patient characteristics, clinical features, and management strategies, and evaluated their outcome. Results The average age of presentation was 30 years with a male:female ratio of 1.03:1. They are commonly seen in the thoracic region (42.3%). The length of cyst was more than two vertebral levels in 85.81%. Mean symptom duration was 29 months, with most common presentation being that of compressive myelopathy. A good clinical outcome was present in symptomatic patients who had a shorter symptom duration and underwent complete surgical excision of the SEAC. Age, sex, length of lesion, and presence of dural defect did not have a bearing on the surgical outcome. Conclusion For thoracic compressive myelopathy in a young patient, SEAC should be kept as a differential diagnosis. Surgical complete excision of the cyst with meticulous closure of the dural defect is the standard in management for a good clinical outcome.
format Article
id doaj-art-47b96c8f72534b328545eb6fd0bb6db5
institution OA Journals
issn 2277-954X
2277-9167
language English
publishDate 2023-03-01
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series Indian Journal of Neurosurgery
spelling doaj-art-47b96c8f72534b328545eb6fd0bb6db52025-08-20T02:37:53ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672023-03-01120100300910.1055/s-0041-1731623Clinical Profile and Treatment Outcome of Spinal Epidural Arachnoid Cysts: A Systematic Review of Case Studies and ReportsAditya K. Patil0Srikant K. Swain1Suresh Sharma2Rajnish Kumar Arora3Achal Sharma4Poonam Arora5Radhey S. Mittal6Department of Neurosurgery, All India Institute of Medical Sciences, Dehradun, Uttarakhand, IndiaDepartment of Neurosurgery, All India Institute of Medical Sciences, Dehradun, Uttarakhand, IndiaCollege of Nursing, All India Institute of Medical Sciences, Dehradun, Uttarakhand, IndiaDepartment of Neurosurgery, All India Institute of Medical Sciences, Dehradun, Uttarakhand, IndiaDepartment of Neurosurgery, SMS Medical College, Jaipur, Rajasthan, IndiaDepartment of Emergency Medicine, All India Institute of Medical Sciences, Dehradun, Uttarakhand, IndiaDepartment of Neurosurgery, All India Institute of Medical Sciences, Dehradun, Uttarakhand, IndiaBackground A spinal epidural arachnoid cyst (SEAC) is a rare clinical entity. We performed a systematic review of the literature to obtain information regarding demographics, clinical presentation, treatment modalities, and outcome of SEACs. Methods A literature search was performed by using the databases PubMed/Medline, PubMed Central, Embase, Cochrane Library, Ovid MEDLINE, and Ovid Medline In-Process. A total of 170 articles were found on literature search. We found 575 cases of SEAC since 1904 for inclusion in the review including three cases which were operated by us. We studied the patient characteristics, clinical features, and management strategies, and evaluated their outcome. Results The average age of presentation was 30 years with a male:female ratio of 1.03:1. They are commonly seen in the thoracic region (42.3%). The length of cyst was more than two vertebral levels in 85.81%. Mean symptom duration was 29 months, with most common presentation being that of compressive myelopathy. A good clinical outcome was present in symptomatic patients who had a shorter symptom duration and underwent complete surgical excision of the SEAC. Age, sex, length of lesion, and presence of dural defect did not have a bearing on the surgical outcome. Conclusion For thoracic compressive myelopathy in a young patient, SEAC should be kept as a differential diagnosis. Surgical complete excision of the cyst with meticulous closure of the dural defect is the standard in management for a good clinical outcome.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731623spinal epidural arachnoid cystspinal extraduraldural defect repair
spellingShingle Aditya K. Patil
Srikant K. Swain
Suresh Sharma
Rajnish Kumar Arora
Achal Sharma
Poonam Arora
Radhey S. Mittal
Clinical Profile and Treatment Outcome of Spinal Epidural Arachnoid Cysts: A Systematic Review of Case Studies and Reports
Indian Journal of Neurosurgery
spinal epidural arachnoid cyst
spinal extradural
dural defect repair
title Clinical Profile and Treatment Outcome of Spinal Epidural Arachnoid Cysts: A Systematic Review of Case Studies and Reports
title_full Clinical Profile and Treatment Outcome of Spinal Epidural Arachnoid Cysts: A Systematic Review of Case Studies and Reports
title_fullStr Clinical Profile and Treatment Outcome of Spinal Epidural Arachnoid Cysts: A Systematic Review of Case Studies and Reports
title_full_unstemmed Clinical Profile and Treatment Outcome of Spinal Epidural Arachnoid Cysts: A Systematic Review of Case Studies and Reports
title_short Clinical Profile and Treatment Outcome of Spinal Epidural Arachnoid Cysts: A Systematic Review of Case Studies and Reports
title_sort clinical profile and treatment outcome of spinal epidural arachnoid cysts a systematic review of case studies and reports
topic spinal epidural arachnoid cyst
spinal extradural
dural defect repair
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731623
work_keys_str_mv AT adityakpatil clinicalprofileandtreatmentoutcomeofspinalepiduralarachnoidcystsasystematicreviewofcasestudiesandreports
AT srikantkswain clinicalprofileandtreatmentoutcomeofspinalepiduralarachnoidcystsasystematicreviewofcasestudiesandreports
AT sureshsharma clinicalprofileandtreatmentoutcomeofspinalepiduralarachnoidcystsasystematicreviewofcasestudiesandreports
AT rajnishkumararora clinicalprofileandtreatmentoutcomeofspinalepiduralarachnoidcystsasystematicreviewofcasestudiesandreports
AT achalsharma clinicalprofileandtreatmentoutcomeofspinalepiduralarachnoidcystsasystematicreviewofcasestudiesandreports
AT poonamarora clinicalprofileandtreatmentoutcomeofspinalepiduralarachnoidcystsasystematicreviewofcasestudiesandreports
AT radheysmittal clinicalprofileandtreatmentoutcomeofspinalepiduralarachnoidcystsasystematicreviewofcasestudiesandreports