Twist technique for removal of spinal extradural arachnoid cyst: technical note (우리들병원 은상수 진료부장 European spine journal 논문 게재)

우리들병원 은상수 진료부장님이 European Spine Journal에 논문을 게재하셨습니다.

European Spine Journal은 최근 발표된 2013 impact factor에서 2.473까지 오른 영향력있는 척추전문저널 입니다.

이 논문에서는 손상에 의해 발생되는 경막 외 낭종을 제거하기 위한 새로운 방법으로서 낭종을 바로 잘라내지 않고 꼬아서 확실히 닫아 봉합한 후 제거하는 방법을 제시하고 한 증례를 보고하였습니다. 기존의 방법에 비해 안전하고 효과적인 방법이라는 결론 입니다.

아래 링크로 따라가시면 저자가 연구에 대해 쉽게 설명한 동영상이 있습니다^^

http://www.youtube.com/watch?v=wjV-szb2zjM&feature=youtu.be

*Title: Twist technique for removal of spinal extradural arachnoid cyst: technical note.

경막외 지주막 낭종 제거의 새로운 치료법

*Authors: Lee SH, Shim HK, Eun SS

*Bibliography: Eur Spine J. 2014Aug;23(8):1755-60.

STUDY DESIGN

We document a spinal extradual arachnoid cyst treated by twist technique. The cyst is tightly adherent to the neural tissue or the dura, and the communication stalk is little or short.

OBJECTIVE

To demonstrate the effectiveness of twist technique of closure of the communication stalk for the removal of spinal extradural arachnoid cyst.

METHODS

▶Subject: 44-year-old woman presented with a 10-year history of pain and dysesthesia

(initially in the posterior neck region and extending gradually to the distal portion of the right upper extremity)

-Pain and dysesthesia were exaggerated when she was lying down and relieved when standing or walking. She was diagnosed with an extradural arachnid cyst ranging from spinal regions T1 to T3 using MRI.

-Computerized tomography myelography revealed a mass located posterior to the spinal cord.

-Pooling of contrast medium was observed in the lesion indicating communication with the subarachnoid space.

-Laminectomy of the T1-T3 region was performed, preserving the spinous processes and the facet joints.

-A short communication stalk was found at the proximal root sleeve of right T3. This stalk was closed using twist technique.

RESULTS

-The patient experienced marked reduction of pain and dysesthesia after surgery, and the headache and blurred vision completely disappeared.

-5 days after the operation, she was discharged home in good condition. Postoperative 1 year later, the patient had completely recovered and resumed her normal life.

CONCLUSIONS

Twist technique can be seen safe and effective as another surgical option for spinal extradural arachnoid cysts containing a short stalk and dense fibrous adhesion with the dura mater.