Thoracic spinal arachnoid web and syringomyelia with rostral expansion to the first cervical spinal cord level: Case report

Introduction and importance: A spinal arachnoid web is a rare pathology that has been associated with the development of syringomyelia. Syrinx expansion can occur, which can result in the development of new symptoms. In the current literature, the farthest rostral expansion of the associated syrinx...

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Main Authors: Lastra-Power, J. (Author), Layuno-Matos, J.G (Author), Nieves-Ríos, C. (Author), Olivella, G. (Author), Ramírez, N. (Author), Weber-Seda, C. (Author)
Format: Article
Language:English
Published: Elsevier Ltd 2022
Subjects:
Online Access:View Fulltext in Publisher
LEADER 02464nam a2200253Ia 4500
001 10.1016-j.ijscr.2022.107360
008 220718s2022 CNT 000 0 und d
020 |a 22102612 (ISSN) 
245 1 0 |a Thoracic spinal arachnoid web and syringomyelia with rostral expansion to the first cervical spinal cord level: Case report 
260 0 |b Elsevier Ltd  |c 2022 
856 |z View Fulltext in Publisher  |u https://doi.org/10.1016/j.ijscr.2022.107360 
520 3 |a Introduction and importance: A spinal arachnoid web is a rare pathology that has been associated with the development of syringomyelia. Syrinx expansion can occur, which can result in the development of new symptoms. In the current literature, the farthest rostral expansion of the associated syrinx has been to the C3 spinal level. Case presentation: We present a 49-year-old Hispanic male with a thoracic spinal arachnoid web and an associated syrinx spanning from C1 to T7 spinal level. The patient developed upper extremities radicular symptoms that worsened over time. He underwent surgical management with T6–8 laminectomy and excision of the web. Postoperative follow-up evaluations demonstrated progressive clinical improvement with eventual resolution of symptoms and syringomyelia. Clinical discussion: Syringomyelia secondary to a thoracic spinal arachnoid web is a progressive disease that can expand rostrally to the C1 spinal level. The clinical presentation usually involves the lower extremities. However, if the upper thoracic or cervical spinal cord is involved, patients can also present symptoms in the upper extremities. Management usually involves surgical excision of the web in order to decompress the subarachnoid space and restore the normal cerebrospinal fluid (CSF) flow. Conclusion: Our case suggests that syringomyelia secondary to a spinal arachnoid web may continuously expand with concomitant worsening of symptoms. However, surgical resection is curative with possible remission of symptoms and normalization of spinal anatomy. © 2022 The Authors 
650 0 4 |a Arachnoid web 
650 0 4 |a Case report 
650 0 4 |a Cervical spine 
650 0 4 |a Scalpel sign 
650 0 4 |a Syringomyelia 
700 1 |a Lastra-Power, J.  |e author 
700 1 |a Layuno-Matos, J.G.  |e author 
700 1 |a Nieves-Ríos, C.  |e author 
700 1 |a Olivella, G.  |e author 
700 1 |a Ramírez, N.  |e author 
700 1 |a Weber-Seda, C.  |e author 
773 |t International Journal of Surgery Case Reports