PMC8326061_01
(a) Sagittal T2-weighted magnetic resonance image (MRI) of the thoracic spine showing the spinal cord anteriorly displaced at the level of T7, with enlargement of the dorsal liquor space ("scalpel sign") and narrowing of the spinal cord, associated with the inferior syringomyelia area. (b) Axial T2-weighted MRI of the thoracic spine showing the spinal cord anteriorly displaced by arachnoid web.
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F1
T6- T7 that showed a thickened AW consistent with an AW, and microdissection released the adhesions resulting in spinal cord reexpansion [Figure 5]. The postoperative MR 1 month later was normal, and the patient at 4 postoperative months regained normal function [Figure 6] [Table 1].
Intraoperative photography obtained in case 1. (a and b) Intraoperative appearance after midline durotomy. Removal of the dura mater, observing the presence of spinal narrowing caused by arachnoid thickening shown by the white arrow. Normal spinal cord is visualized as cranial and rostral.
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F2
After the opening the arachnoid, exposing the dorsal cord, there were multiple septate membranes between the dura and the spinal cord that thick fibrotic tissue appeared to strange the cord (i.e. adhesions to the ventral dura, contributed to cord compression) [Figure 2].
Postoperative magnetic resonance images (MRI) obtained in the patient in Case 1. Sagittal T2-weighted MRI of the thoracic spine showing resolution of the arachnoid web at T7 level and persistence of residual syringomyelia.
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F3
The 3 months postoperative MR showed resolution of spinal compression and but residual syringomyelia [Figure 3].
PMC8326061_02
(a) Sagittal T2-weighted magnetic resonance image (MRI) of the thoracic spine showing the spinal cord anteriorly displaced at the level of T7, with enlargement of the dorsal liquor space ("scalpel sign") and narrowing of the spinal cord, associated with the inferior syringomyelia area. (b) Axial T2-weighted MRI of the thoracic spine showing the spinal cord anteriorly displaced by arachnoid web.
SNI-12-316-g001.jpg
PMC8326061_02_SNI-12-316-g001.jpg
F1
T6- T7 that showed a thickened AW consistent with an AW, and microdissection released the adhesions resulting in spinal cord reexpansion [Figure 5]. The postoperative MR 1 month later was normal, and the patient at 4 postoperative months regained normal function [Figure 6] [Table 1].
Preoperative magnetic resonance images (MRI) obtained in the patient in Case 2. Sagittal T2-weighted MRI of the thoracic spine showing the spinal cord anteriorly displaced at the level of T7, with enlargement of the spinal cord liquor ("scalpel sign") and narrowing of the spinal cord. Hypersignal indicating segmental myelopathy.
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F4
The thoracic MRI of again showed the spinal cord displaced at the T7 level, with a central syrinx [Figure 4].
(a-c) Intraoperative photography obtained in case 2 showing the microdissection of the arachnoid web and the removal of arachnoid thickening.
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F5
T6- T7 that showed a thickened AW consistent with an AW, and microdissection released the adhesions resulting in spinal cord reexpansion [Figure 5]. The postoperative MR 1 month later was normal, and the patient at 4 postoperative months regained normal function [Figure 6] [Table 1].
(a) Postoperative magnetic resonance images (MRI) obtained in the patient in Case 2. Sagittal T2-weighted MRI of the thoracic spine showing resolution of the arachnoid web at the T7 level. (b) Axial T2-weighted MRI of the thoracic spine at the T7 level showing improvement of spinal cord displacement.
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F6
T6- T7 that showed a thickened AW consistent with an AW, and microdissection released the adhesions resulting in spinal cord reexpansion [Figure 5]. The postoperative MR 1 month later was normal, and the patient at 4 postoperative months regained normal function [Figure 6] [Table 1].