Severe Kyphoscoliosis Associated with Multiple Giant Intraspinal Epidural Cysts: A Case Report and Literature Review.

Abstract

Severe kyphoscoliosis associated with multiple giant spinal epidural arachnoid cysts (SEACs) is an extremely rare condition and remains a challenge in clinical practice. This study aimed to present a case of severe spinal deformity associated with multiple giant SEACs and to discuss strategies for the preoperative diagnosis and treatment. A 22-year-old man with severe thoracolumbar kyphoscoliosis associated with multiple giant SEACs presented with progressive scoliosis, spastic paralysis, numbness, and abnormal gait. X-ray and magnetic resonance imaging revealed severe rigid kyphoscoliosis, extensive diffuse cystic space-occupying lesions, and diffuse spinal cord compression. After multidisciplinary consultation and discussion, the patient underwent a cyst-peritoneal shunting surgery followed by posterior vertebral column resection (PVCR) correction. The postoperative course was uneventful. Both kyphosis and scoliosis were significantly corrected, and muscle weakness of the lower extremities and sensory disturbance partially improved. At the 2-year follow-up visit, the patient could freely walk without the aid of crutches, but there were some residual neurologic deficits in both legs. A plain radiograph showed that bony fusion was achieved, and the correction was well maintained. Cyst-peritoneal shunting surgery followed by PVCR, as in our case, could be an alternative surgical strategy for multiple giant SEACs associated with severe rigid kyphoscoliosis.