{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:57:24Z","timestamp":1770353844565,"version":"3.49.0"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"21","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,20]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spinal extradural arachnoid cysts (SEACs) are rare and can cause spinal dysfunction. Total cyst removal and duraplasty via multiple laminectomies are commonly performed. However, to avoid postoperative spinal deformity and axial pain, a minimally invasive surgery via selective laminectomy may be optimal. Therefore, preoperative detection of the dural fistula site is required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 25-year-old male presented with a 2-month history of progressive gait disturbance and back pain. Conventional magnetic resonance imaging (MRI) revealed SEACs at the T9 to L2 level but did not reveal the dural fistula. Further examinations were performed using sagittal time-spatial labeling inversion pulse MRI and cone-beam computed tomography myelography with a spinal intrathecal catheter, which indicated a dural fistula on the left side at the T12 level. On the basis of these results, dural repair was performed via selective laminectomy. Furthermore, an intraoperative cerebrospinal fluid leakage test by intrathecally injecting saline via a spinal catheter confirmed complete closure of the dural fistula, with no other fistulas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>These comprehensive pre and intraoperative examinations may be useful for minimally invasive and selective surgeries in patients with SEACs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23319","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T19:23:42Z","timestamp":1700508222000},"source":"Crossref","is-referenced-by-count":0,"title":["Preoperative examination and intraoperative cerebrospinal fluid leakage test for minimally invasive surgery of spinal extradural arachnoid cysts: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Yoshihiro","family":"Sunada","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Yagi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshifumi","family":"Tao","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotake","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Pathology, Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohito","family":"Hishikawa","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Neurosurg","first-page":"366","article-title":"Updated assessment and current classification of spinal meningeal cysts","volume":"68","author":"Nabors MW","year":"1988","unstructured":"Nabors MW, Pait TG, Byrd EB,  Updated assessment and current classification of spinal meningeal cysts. J Neurosurg. 1988;68(3):366\u2013377."},{"key":"b2","series-title":"World Neurosurg","first-page":"343","article-title":"Spinal extradural cyst: case report and review of literature","volume":"116","author":"Lee SW","year":"2018","unstructured":"Lee SW, Foo A, Tan CL,  Spinal extradural cyst: case report and review of literature. World Neurosurg. 2018;116:343\u2013346."},{"issue":"7","key":"b3","series-title":"Acta Neurochir (Wien)","first-page":"1219","article-title":"What is a reasonable surgical procedure for spinal extradural arachnoid cysts: is cyst removal mandatory? Eight consecutive cases and a review of the literature","volume":"154","author":"Lee CH","year":"2012","unstructured":"Lee CH, Hyun SJ, Kim KJ, Jahng TA, Kim HJ What is a reasonable surgical procedure for spinal extradural arachnoid cysts: is cyst removal mandatory? Eight consecutive cases and a review of the literature. Acta Neurochir (Wien). 2012;154(7):1219\u20131227."},{"issue":"5","key":"b4","series-title":"Clin Neurol Neurosurg","first-page":"460","article-title":"Nerve root prolapse into a spinal arachnoid cyst\u2014an unusual cause of radiculopathy","volume":"111","author":"Sangala JR","year":"2009","unstructured":"Sangala JR, Uribe JS, Park P, Martinez C, Vale FL Nerve root prolapse into a spinal arachnoid cyst\u2014an unusual cause of radiculopathy. Clin Neurol Neurosurg. 2009;111(5):460\u2013464."},{"issue":"3","key":"b5","series-title":"J Neurosurg","first-page":"266","article-title":"Noncommunicating spinal extradural arachnoid cyst causing spinal cord compression in a child","volume":"103","author":"Liu JK","year":"2005","unstructured":"Liu JK, Cole CD, Sherr GT, Kestle JR, Walker ML Noncommunicating spinal extradural arachnoid cyst causing spinal cord compression in a child. J Neurosurg. 2005;103(3\n \nsuppl\n):266\u2013269."},{"issue":"5","key":"b6","series-title":"Ann Surg","first-page":"851","article-title":"Congenital spinal extradural cysts: case report with review of literature","volume":"168","author":"Cloward RB","year":"1968","unstructured":"Cloward RB Congenital spinal extradural cysts: case report with review of literature. Ann Surg. 1968;168(5):851\u2013864."},{"key":"b7","series-title":"World Neurosurg","first-page":"686.e13","article-title":"Long segment spinal dural cyst: a case report","volume":"88","author":"Aoyama T","year":"2016","unstructured":"Aoyama T, Miyaoka Y, Ogiwara T, Ito K, Seguchi T, Hongo K Long segment spinal dural cyst: a case report. World Neurosurg. 2016;88:686.e13\u2013686.e17."},{"issue":"2","key":"b8","series-title":"J Neurosurg","first-page":"310","article-title":"Dural cysts in the cervical region. Report of three cases and review of the literature","volume":"89","author":"Hamburger CH","year":"1998","unstructured":"Hamburger CH, B\u00fcttner A, Weis S Dural cysts in the cervical region. Report of three cases and review of the literature. J Neurosurg. 1998;89(2):310\u2013313."},{"issue":"5","key":"b9","series-title":"Br J Neurosurg","first-page":"484","article-title":"Extradural arachnoid cysts: a study of seven cases","volume":"18","author":"Kulkarni AG","year":"2004","unstructured":"Kulkarni AG, Goel A, Thiruppathy SP, Desai K Extradural arachnoid cysts: a study of seven cases. Br J Neurosurg. 2004;18(5):484\u2013488."},{"issue":"1","key":"b10","series-title":"Spinal Cord","first-page":"59","article-title":"Multiple extradural arachnoid cysts at the spinal cord and cauda equina levels in the young","volume":"44","author":"Takagaki T","year":"2006","unstructured":"Takagaki T, Nomura T, Toh E, Watanabe M, Mochida J Multiple extradural arachnoid cysts at the spinal cord and cauda equina levels in the young. Spinal Cord. 2006;44(1):59\u201362."},{"issue":"23","key":"b11","series-title":"Spine (Phila Pa 1976)","first-page":"E1394","article-title":"Detection of the communicating hole(s) of spinal extradural arachnoid cysts using time-spatial labeling inversion pulse magnetic resonance imaging","volume":"39","author":"Ishibe T","year":"2014","unstructured":"Ishibe T, Senzoku F, Ikeda N, Kamba Y, Mikawa Y Detection of the communicating hole(s) of spinal extradural arachnoid cysts using time-spatial labeling inversion pulse magnetic resonance imaging. 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Neurosurgery. 2012;71(2):278\u2013284, discussion 284."},{"issue":"6","key":"b15","series-title":"Surg Neurol","first-page":"533","article-title":"Cine-mode magnetic resonance imaging of a thoracic intradural arachnoid cyst: case report","volume":"45","author":"Fujimura M","year":"1996","unstructured":"Fujimura M, Tominaga T, Koshu K, Shimizu H, Yoshimoto T Cine-mode magnetic resonance imaging of a thoracic intradural arachnoid cyst: case report. 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Minim Invasive Neurosurg. 2004;47(6):369\u2013372."},{"issue":"2","key":"b17","series-title":"Nerve","first-page":"136","article-title":"Minimally invasive surgery of spinal extradural arachnoid cyst with high-resolution myelography: a case report","volume":"6","author":"Lee JH","year":"2020","unstructured":"Lee JH, Yoo SC, Chough CK Minimally invasive surgery of spinal extradural arachnoid cyst with high-resolution myelography: a case report. Nerve. 2020;6(2):136\u2013138."},{"issue":"4","key":"b18","series-title":"Neurosurgery","first-page":"E941","article-title":"Utility of preoperative magnetic resonance imaging myelography for identifying dural defects in patients with spinal extradural arachnoid cysts: case report","volume":"59","author":"Miyamoto M","year":"2006","unstructured":"Miyamoto M, Kim K, Matsumoto R, Isobe M, Isu T Utility of preoperative magnetic resonance imaging myelography for identifying dural defects in patients with spinal extradural arachnoid cysts: case report. Neurosurgery. 2006;59(4):E941."},{"issue":"1","key":"b19","series-title":"Korean J Spine","first-page":"28","article-title":"Large thoracolumbar extradural arachnoid cyst excised by minimal skipped hemilaminectomy: a case report","volume":"10","author":"Lee HJ","year":"2013","unstructured":"Lee HJ, Cho WH, Han IH, Choi BK Large thoracolumbar extradural arachnoid cyst excised by minimal skipped hemilaminectomy: a case report. Korean J Spine. 2013;10(1):28\u201331."},{"issue":"2","key":"b20","series-title":"Korean J Neurotrauma","first-page":"360","article-title":"How to find dural defect of spinal extradural arachnoid cyst","volume":"16","author":"Lee SW","year":"2020","unstructured":"Lee SW, Choi SW, Lim J,  How to find dural defect of spinal extradural arachnoid cyst. Korean J Neurotrauma. 2020;16(2):360\u2013366."},{"issue":"4","key":"b21","series-title":"J Neurol Neurosurg Psychiatry","first-page":"468","article-title":"Bacterial meningitis associated with lumbar drains: a retrospective cohort study","volume":"67","author":"Coplin WM","year":"1999","unstructured":"Coplin WM, Avellino AM, Kim DK, Winn HR, Grady MS Bacterial meningitis associated with lumbar drains: a retrospective cohort study. 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JAMA. 2020;324(14):1419\u20131428."},{"key":"b24","series-title":"World Neurosurg","first-page":"130","article-title":"Ultrafine flexible endoscope visualization to assist in the removal of a huge spinal extradural arachnoid cyst: case report and literature review","volume":"159","author":"Zhang P","year":"2022","unstructured":"Zhang P, Liu H, Sun Z, Guo Y, Wang G, Wang JJ Ultrafine flexible endoscope visualization to assist in the removal of a huge spinal extradural arachnoid cyst: case report and literature review. World Neurosurg. 2022;159:130\u2013133."},{"issue":"1","key":"b25","series-title":"Acta Med Okayama","first-page":"73","article-title":"Spinal extradural arachnoid cyst: significance of intrathecal infusion after fistula closure","volume":"72","author":"Umakoshi M","year":"2018","unstructured":"Umakoshi M, Yasuhara T, Toyoshima A,  Spinal extradural arachnoid cyst: significance of intrathecal infusion after fistula closure. 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Radiology. 2002;223(3):767\u2013771."},{"issue":"5","key":"b29","series-title":"J Spinal Cord Med","first-page":"499","article-title":"Marfan syndrome and symptomatic sacral cyst: report of two cases","volume":"36","author":"Arnold PM","year":"2013","unstructured":"Arnold PM, Teuber J Marfan syndrome and symptomatic sacral cyst: report of two cases. J Spinal Cord Med. 2013;36(5):499\u2013503."},{"issue":"11","key":"b30","series-title":"PLoS One","first-page":"e80548","article-title":"FOXC2 mutations in familial and sporadic spinal extradural arachnoid cyst","volume":"8","author":"Ogura Y","year":"2013","unstructured":"Ogura Y, Yabuki S, Iida A,  FOXC2 mutations in familial and sporadic spinal extradural arachnoid cyst. PLoS One. 2013;8(11):e80548."},{"key":"b31","series-title":"Hum Genome Var","first-page":"15032","article-title":"A novel FOXC2 mutation in spinal extradural arachnoid cyst","volume":"2","author":"Ogura Y","year":"2015","unstructured":"Ogura Y, Fujibayashi S, Iida A,  A novel FOXC2 mutation in spinal extradural arachnoid cyst. Hum Genome Var. 2015;2:15032."},{"issue":"8","key":"b32","series-title":"Genet Med","first-page":"532","article-title":"Spinal extradural arachnoid cysts in lymphedema-distichiasis syndrome","volume":"12","author":"S\u00e1nchez-Carpintero R","year":"2010","unstructured":"S\u00e1nchez-Carpintero R, Dominguez P, N\u00fa\u00f1ez MT, Pati\u00f1o-Garc\u00eda A Spinal extradural arachnoid cysts in lymphedema-distichiasis syndrome. Genet Med. 2010;12(8):532\u2013535."},{"issue":"3","key":"b1","series-title":"J Neurosurg","first-page":"366","article-title":"Updated assessment and current classification of spinal meningeal cysts","volume":"68","author":"Nabors MW","year":"1988","unstructured":"Nabors MW, Pait TG, Byrd EB,  Updated assessment and current classification of spinal meningeal cysts. J Neurosurg. 1988;68(3):366\u2013377."},{"key":"b2","series-title":"World Neurosurg","first-page":"343","article-title":"Spinal extradural cyst: case report and review of literature","volume":"116","author":"Lee SW","year":"2018","unstructured":"Lee SW, Foo A, Tan CL,  Spinal extradural cyst: case report and review of literature. World Neurosurg. 2018;116:343\u2013346."},{"issue":"7","key":"b3","series-title":"Acta Neurochir (Wien)","first-page":"1219","article-title":"What is a reasonable surgical procedure for spinal extradural arachnoid cysts: is cyst removal mandatory? 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Clin Neurol Neurosurg. 2009;111(5):460\u2013464."},{"issue":"3","key":"b5","series-title":"J Neurosurg","first-page":"266","article-title":"Noncommunicating spinal extradural arachnoid cyst causing spinal cord compression in a child","volume":"103","author":"Liu JK","year":"2005","unstructured":"Liu JK, Cole CD, Sherr GT, Kestle JR, Walker ML Noncommunicating spinal extradural arachnoid cyst causing spinal cord compression in a child. J Neurosurg. 2005;103(3\n \nsuppl\n):266\u2013269."},{"issue":"5","key":"b6","series-title":"Ann Surg","first-page":"851","article-title":"Congenital spinal extradural cysts: case report with review of literature","volume":"168","author":"Cloward RB","year":"1968","unstructured":"Cloward RB Congenital spinal extradural cysts: case report with review of literature. Ann Surg. 1968;168(5):851\u2013864."},{"key":"b7","series-title":"World Neurosurg","first-page":"686.e13","article-title":"Long segment spinal dural cyst: a case report","volume":"88","author":"Aoyama T","year":"2016","unstructured":"Aoyama T, Miyaoka Y, Ogiwara T, Ito K, Seguchi T, Hongo K Long segment spinal dural cyst: a case report. World Neurosurg. 2016;88:686.e13\u2013686.e17."},{"issue":"2","key":"b8","series-title":"J Neurosurg","first-page":"310","article-title":"Dural cysts in the cervical region. Report of three cases and review of the literature","volume":"89","author":"Hamburger CH","year":"1998","unstructured":"Hamburger CH, B\u00fcttner A, Weis S Dural cysts in the cervical region. Report of three cases and review of the literature. J Neurosurg. 1998;89(2):310\u2013313."},{"issue":"5","key":"b9","series-title":"Br J Neurosurg","first-page":"484","article-title":"Extradural arachnoid cysts: a study of seven cases","volume":"18","author":"Kulkarni AG","year":"2004","unstructured":"Kulkarni AG, Goel A, Thiruppathy SP, Desai K Extradural arachnoid cysts: a study of seven cases. Br J Neurosurg. 2004;18(5):484\u2013488."},{"issue":"1","key":"b10","series-title":"Spinal Cord","first-page":"59","article-title":"Multiple extradural arachnoid cysts at the spinal cord and cauda equina levels in the young","volume":"44","author":"Takagaki T","year":"2006","unstructured":"Takagaki T, Nomura T, Toh E, Watanabe M, Mochida J Multiple extradural arachnoid cysts at the spinal cord and cauda equina levels in the young. Spinal Cord. 2006;44(1):59\u201362."},{"issue":"23","key":"b11","series-title":"Spine (Phila Pa 1976)","first-page":"E1394","article-title":"Detection of the communicating hole(s) of spinal extradural arachnoid cysts using time-spatial labeling inversion pulse magnetic resonance imaging","volume":"39","author":"Ishibe T","year":"2014","unstructured":"Ishibe T, Senzoku F, Ikeda N, Kamba Y, Mikawa Y Detection of the communicating hole(s) of spinal extradural arachnoid cysts using time-spatial labeling inversion pulse magnetic resonance imaging. 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Spine (Phila Pa 1976). 2004;29(19):E426\u2013E430."},{"issue":"1","key":"b13","series-title":"BMC Surg","first-page":"11","article-title":"Utilizing real-time contrast medium to detect the fistula of giant spinal arachnoid cyst and treat with minimal invasive surgery","volume":"19","author":"Ying GY","year":"2019","unstructured":"Ying GY, Chang KS, Tang YJ, Cheng CY, Zhu YJ, Chen CM Utilizing real-time contrast medium to detect the fistula of giant spinal arachnoid cyst and treat with minimal invasive surgery. BMC Surg. 2019;19(1):11."},{"issue":"2","key":"b14","series-title":"Neurosurgery","first-page":"278","article-title":"Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine","volume":"71","author":"Funao H","year":"2012","unstructured":"Funao H, Nakamura M, Hosogane N,  Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine. Neurosurgery. 2012;71(2):278\u2013284, discussion 284."},{"issue":"6","key":"b15","series-title":"Surg Neurol","first-page":"533","article-title":"Cine-mode magnetic resonance imaging of a thoracic intradural arachnoid cyst: case report","volume":"45","author":"Fujimura M","year":"1996","unstructured":"Fujimura M, Tominaga T, Koshu K, Shimizu H, Yoshimoto T Cine-mode magnetic resonance imaging of a thoracic intradural arachnoid cyst: case report. 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Minim Invasive Neurosurg. 2004;47(6):369\u2013372."},{"issue":"2","key":"b17","series-title":"Nerve","first-page":"136","article-title":"Minimally invasive surgery of spinal extradural arachnoid cyst with high-resolution myelography: a case report","volume":"6","author":"Lee JH","year":"2020","unstructured":"Lee JH, Yoo SC, Chough CK Minimally invasive surgery of spinal extradural arachnoid cyst with high-resolution myelography: a case report. Nerve. 2020;6(2):136\u2013138."},{"issue":"4","key":"b18","series-title":"Neurosurgery","first-page":"E941","article-title":"Utility of preoperative magnetic resonance imaging myelography for identifying dural defects in patients with spinal extradural arachnoid cysts: case report","volume":"59","author":"Miyamoto M","year":"2006","unstructured":"Miyamoto M, Kim K, Matsumoto R, Isobe M, Isu T Utility of preoperative magnetic resonance imaging myelography for identifying dural defects in patients with spinal extradural arachnoid cysts: case report. Neurosurgery. 2006;59(4):E941."},{"issue":"1","key":"b19","series-title":"Korean J Spine","first-page":"28","article-title":"Large thoracolumbar extradural arachnoid cyst excised by minimal skipped hemilaminectomy: a case report","volume":"10","author":"Lee HJ","year":"2013","unstructured":"Lee HJ, Cho WH, Han IH, Choi BK Large thoracolumbar extradural arachnoid cyst excised by minimal skipped hemilaminectomy: a case report. 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