机构:[1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.神经科系统神经外科首都医科大学宣武医院[2]Lab of Spinal Cord, Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China[3]Department of Neurosurgery, Hospital Sultanah Aminah and Gleneagles Hospital Johor, Malaysia.
Intraspinal cysts are uncommon, and the success rate of complete resection is still low for spinal neurenteric cysts (NCs). The aim of this study was to evaluate the efficacies of an anterior microscopic surgical approach in the treatment of ventral and ventrolateral subaxial cervical NCs (SCNCs).Between 2019 and 2022, 9 patients with NCs of the subaxial spine underwent an anterior microsurgical approach. Their clinical presentations, radiological features, operative findings, and follow-up data were retrospectively reviewed and analyzed.All spinal cysts were intradural and extramedullary in origin. Five patients were first-time cases while 4 patients with recurrence underwent revision surgery. The most common clinical manifestation was pain (77.78%). One patient was found to have a concomitant disorder of Klippel-Feil syndrome. Microscopically confirmed gross-total resection was achieved in 8 patients (88.89%) based on clinical comparisons between pre- and postoperative MRI and intraoperative video. One patient had symptom recurrence 1 year after subtotal resection, while there was no evidence of recurrence during follow-up for the other patients. Dense adhesions within the spinal cord were observed in 8 patients (88.89%) intraoperatively. Most importantly, the surgical outcome was significantly improved in all patients, and the mean (± SE) Japanese Orthopaedic Association score increased from 11.33 ± 0.91 preoperatively to 16.22 ± 0.32 postoperatively (p = 0.008).An anterior surgical approach was proven to be both safe and effective in treating the ventral or ventrolateral SCNCs. The authors believe that an anterior microsurgical approach should be considered as a useful approach especially in patients with ventral recurrent SCNCs. Its clinical efficacy compared with a posterior approach in ventral spinal cyst may be better as most of the neurenteric cysts are ventrally or ventrolaterally located.
基金:
Beijing Natural Science Foundation (grant no. L212039), National High Level Hospital Clinical Research Funding (2022-PUMCH-D-004). The “Young Talents” Program supported by Beijing Municipal Hospital Administration (no. QML20210801), research and application of the clinical characteristic diagnosis and treatment program was supported by the Beijing Municipal Science & Technology Commission (no. Z221100007422019), and CAMS Innovation Fund for Medical Sciences (CIFMS #2021-1-I2M-025).
第一作者机构:[1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.[2]Lab of Spinal Cord, Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China
共同第一作者:
通讯作者:
通讯机构:[1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.[2]Lab of Spinal Cord, Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China
推荐引用方式(GB/T 7714):
Xin Zong,Du Yueqi,Zhang Can,et al.Spinal neurenteric cysts: experience with 9 cases via an anterior cervical approach[J].Journal Of Neurosurgery. Spine.2024,41(3):407-415.doi:10.3171/2024.3.SPINE231161.
APA:
Xin Zong,Du Yueqi,Zhang Can,Zhang Boyan,Qi Maoyang...&Duan Wanru.(2024).Spinal neurenteric cysts: experience with 9 cases via an anterior cervical approach.Journal Of Neurosurgery. Spine,41,(3)
MLA:
Xin Zong,et al."Spinal neurenteric cysts: experience with 9 cases via an anterior cervical approach".Journal Of Neurosurgery. Spine 41..3(2024):407-415