Katrien Raes, Kristine M. Oostra
Physical medicine and Rehabilitation, University Hospital of Ghent, Ghent, Belgium.
DOI: 10.2340/20030711-1000066

Background: Spinal arachnoid cysts are rare entities, which are composed of a duplication in the arachnoid membrane and resultant cerebrospinal fluid collection, which may present with a progressive myelopathy. The most common symptoms caused by spinal cord compression are paraesthesia, neuropathic pain, paresis and gait ataxia.
Clinical cases: We report here 2 cases from different perspectives of a spinal arachnoid cysts in spinal cord injury. The first case was the occurrence of a spinal cord injury due to compression of a spinal arachnoid cysts causing myelopathy. The second case is a patient who had a traumatic paraplegia for which stabilizing surgery was required and who subsequently developed a spinal arachnoid cysts with neuropathic pain. Both cases required surgery with immediate improvement. However, after a few months both patients needed a revision due to recurrence.
Conclusion: Spinal arachnoid cysts may present with a heterogeneous clinical picture. If cysts are not clinically apparent, a conservative treatment with careful observation can be a justifiable option. In patients with progressive symptoms, surgery is the gold standard of care. However, the literature describes the need for revision surgery in only 12. 5% of cases. Regular follow-up is necessary because both of the patients reported here needed revision surgery.

Spinal cysts are cerebrospinal fluid pockets that may compress the spinal cord. They may present with different symptoms; for example, sensory disorders, pain, loss of strength and difficulty walking. We report here 2 patients with a spinal cord injury with spinal arachnoid cysts. In the case of patients with worsening symptoms, surgery is the gold standard of care. Regular follow-up is necessary; and both patients reported here needed revision surgery.