A case with multiple recurrent arachnoid webs after simple web resections and the successful treatment by subarachnoid-subarachnoid (S–S) bypass assisted with a fiberscope

JOS Case Reports Pub Date : 2024-07-01 Epub Date: 2024-01-09 DOI:10.1016/j.joscr.2023.12.003

Yasushi Fujiwara , Ryo Ohta , Shinji Kotaka , Yuji Tsuchikawa , Masahiro Yamamoto , Yasushi Murakami , Toshio Nakamae , Naosuke Kamei , Nobuo Adachi , Hideki Manabe

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Abstract

Background

A spinal arachnoid web causes myelopathy because of cerebrospinal fluid (CSF) flow disturbance. Although a simple web resection is the standard treatment, the ideal surgical treatment is still controversial.

Case presentation

A multiple recurrent arachnoid web case is reported. The first recurrence occurred at five years after the first simple web resection and the second recurrence occurred at seven years after the second simple web resection.

A third web resection surgery was performed with a subarachnoid-subarachnoid (S–S) bypass assisted with a fiberscope because a pre-operative cine MRI showed an additional hidden arachnoid web located at two levels caudal. Through a fiberscope, a silicon tube was inserted while penetrating the additional web. For the last five years after the third surgery, there has been no recurrence.

Conclusions

A fiberscopic S–S bypass is useful method to prevent recurrence of arachnoid webs.

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一例简单蛛网膜切除术后复发的多发性蛛网膜，在纤维镜辅助下通过蛛网膜下腔-蛛网膜下腔（S-S）分流术成功治疗

背景由于脑脊液（CSF）流动障碍，脊髓蛛网膜瘤会导致脊髓病变。尽管简单的蛛网膜切除术是标准治疗方法，但理想的手术治疗方法仍存在争议。第一次复发发生在第一次单纯蛛网膜切除术后五年，第二次复发发生在第二次单纯蛛网膜切除术后七年。第三次蛛网膜切除手术是在纤维镜辅助下进行的蛛网膜下腔-蛛网膜（S-S）分流术，因为术前的电影磁共振成像显示在尾部两层还有一个隐藏的蛛网膜。通过纤维镜，插入硅管的同时穿透了额外的蛛网膜。结论纤维镜 S-S 分流术是防止蛛网膜瘤复发的有效方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JOS Case Reports

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