PMC9899478_01
(a) T2-W magnetic resonance imaging (MRI) sagittal (a) and axial (b) images disclose a well-defined uniformly hyperintense (identical to CSF) cystic lesion extending from the lower end of the T12 vertebral body to the lower end of L2 vertebral body causing a mass effect and compression over the cord. The cystic structure is exiting through the bilateral L1-L2 exiting neural foramina and causing mass effect on the exiting nerve roots.
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F1
The thoracolumbar magnetic resonance imaging (MRI) revealed a posterior epidural T12-L2 cystic lesion measuring 1.1 x 6 x 3.3 cm [Figure 1].
(a) Intraoperative images of surgical exposure and cyst resection. (a) Unilateral right approach and preliminary exposure of the cranial portion of the cyst (Arrowhead). (b) Progressive resection of the cyst capsule. (c) Dissection and resection of the lateral recess portion of the cyst. (d) Complete bilateral resection of the cyst through a unilateral approach.
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F2
She underwent a T12-L2 right unilateral laminotomy for bilateral decompression/occlusion of the cyst [Figure 2].
Histopathological examination revealing (a) the inner layer is the cyst lining, composed of meningothelial cells and is partially denuded. (b) The outer layer is composed of supportive fibrous tissue consisting of arachnoid cyst.
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F3
Pathologically, the lesion was a Class 2 Nabor arachnoid cyst [Figure 3].
Magnetic resonance imaging lumbosacral spine sagittal (a) and axial (b) showing complete cyst resection with small fluid collection in the subcutaneous soft tissues at the site of recent surgery.
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F4
Immediately postoperatively, and 1 year later, the patient's symptoms improved/resolved with follow-up MR studies confirming complete cyst resection [Figures 4 and 5].
T2-W magnetic resonance imaging sagittal (a) and axial (b) images show resolution of postoperative changes with decrease in focal extradural CSF collection size.
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F5
Immediately postoperatively, and 1 year later, the patient's symptoms improved/resolved with follow-up MR studies confirming complete cyst resection [Figures 4 and 5].