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Cystic lesions of the spine extrinsic to the cord 2006

General Spine

Anant - Krishnan, MD, Non ASSR Member
Richard Silbergleit, MD, Non ASSR Member
Nafi A Aygun, MD, Non ASSR Member

Scientific Poster

Purpose

To display a variety of cystic conditions such as intradural arachnoid cysts, dural adhesions and bands, extradural arachnoid cysts, synovial cysts and cyst like appearance in spinal cord herniation, that may present on imaging of the spine

Methods & Materials

Retrospectively reviewed MRI and myelograms in patients with cyst like lesions identified either incidentally or as a cause of their symptoms and corroborated where available with surgical findings.

Results

A multitude of conditions can present with increased T2 signal on MR imaging of the thoracic and cervical spine. Among these, intradural arachnoid cysts, which are usually dorsal to the cord (except when acquired), caused smooth impression on the spinal cord and were visualised on CT myelography as filling defects (Figs 1a and 1b). Cord herniation or dural bands in patients with prior surgeries or hemorrhage presented more acutely with abrupt kinking of the cord and/or filling defects.

Conclusion

The vast majority of imaging of the spine is performed for the determination of disc herniation, degeneration and consequent radiculopathy and myelopathy. A small percentage of patients have other causes for these symptoms. These include cysts such as intradural and extradural arachnoid cysts, synovial cysts, cyst like processes from prior alterations of the subarachnoid space or secondary to herniation of the cord through a rent in the dura. By combining their appearance on MRI and (where available) myelography, we have attempted to display these conditions.

Images

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