caa a22 4500 60621402X CHVBK 20210128101050.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00701-015-2484-7 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2484-7 Spinal neurenteric cysts: Associated developmental anomalies and rationale of surgical approaches [Elektronische Daten] [Mukesh Shukla, Sanjay Behari, Guruprasad B, Kuntal Das, Anant Mehrotra, Arun Srivastava, Rabi Sahu, Awadhesh Jaiswal, Manoj Jain] Background: Neurenteric cysts (NC) occur due to failure of separation of neurectoderm from endoderm at the 3rd week of embryogenesis. This study focuses on key clinico-radiological features of NCs, with emphasis on surgical nuances involved in resecting anteriorly placed NC, especially at the foramen magnum (FM). Method: Sixteen consecutive patients having a spinal NC were included. Their clinico-radiological status, surgical nuances and follow-up status were noted. Results: The duration of spasticity/paraparesis/quadriparesis ranged from 15days to 48months. Twelve patients had an intradural extramedullary (IDEM; nine anterior and three anterolateral) cyst and four had an intramedullary (IM) cyst. Six of them had an anteriorly placed FM lesion (five IDEM and one IM). Amongst ten subaxial NCs, four were anterior, two antero-lateral and one postero-lateral; three were IM. Three patients had the characteristic stigmata of occult spinal dysraphism: two, a large mesenteric cyst, and one, a posterior mediastinal cyst. Excision was total in 13 patients. Subtotal excision of tumour capsule was performed for two recurrent cysts and an IM cyst. A far lateral approach was adopted for anteriorly placed FM lesions and posterior laminectomy for subaxial lesions. Histopathology revealed eight type A cysts, four type B cysts and four type C cysts. At follow-up (range, 8months to 12years; median, 60 ± 45.84months), complete neurological recovery occurred in seven patients; six patients had persistent spasticity but only minor disability; two patients had difficulty in walking; and one patient with an anteriorly placed thoracic recurrent NC had sustained neurological deterioration. Conclusions: Surgical difficulties in addressing NCs are related to their anterior or IM location, presence of adhesions and inability to dissect the tumour capsule from the spinal cord due to fibrous or lipomatous connections. The associated developmental anomalies must be specifically sought and addressed. Springer-Verlag Wien, 2015 Neurenteric cyst nationallicence Embryology nationallicence Foramen magnum nationallicence Spinal dyraphism nationallicence Developmental anomaly nationallicence Surgery nationallicence Shukla Mukesh Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut Behari Sanjay Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut B Guruprasad Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut Das Kuntal Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut Mehrotra Anant Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut Srivastava Arun Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut Sahu Rabi Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut Jaiswal Awadhesh Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut Jain Manoj Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut Acta Neurochirurgica Springer Vienna 157/9(2015-09-01), 1601-1610 0001-6268 157:9<1601 2015 157 701 https://doi.org/10.1007/s00701-015-2484-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2484-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shukla Mukesh Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut NATIONALLICENCE 700 1- Behari Sanjay Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut NATIONALLICENCE 700 1- B Guruprasad Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut NATIONALLICENCE 700 1- Das Kuntal Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut NATIONALLICENCE 700 1- Mehrotra Anant Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut NATIONALLICENCE 700 1- Srivastava Arun Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut NATIONALLICENCE 700 1- Sahu Rabi Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut NATIONALLICENCE 700 1- Jaiswal Awadhesh Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut NATIONALLICENCE 700 1- Jain Manoj Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226014, Lucknow, India aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/9(2015-09-01), 1601-1610 0001-6268 157:9<1601 2015 157 701