Percutaneous aspiration of spinal terminal ventricle cysts using real-time magnetic resonance imaging and navigation.

摘要

STUDY DESIGN: Clinical case series. OBJECTIVE: To present a new innovative treatment option for cysts of the terminal ventricle. SUMMARY OF BACKGROUND DATA: Invasive surgery including laminectomy and cyst fenestration has been the sole reported method of treatment for this rare pathology. METHODS: Four cases of symptomatic cyst of the terminal ventricle of the spinal cord were treated by percutaneous aspiration using real-time guidance with magnetic resonance imaging (MRI) and optically-tracking navigation. RESULTS: Three patients were treated successfully by this percutaneous method, and for 1 patient the treatment was converted to conventional surgery after a single unsuccessful trial of percutaneous puncture. All patients were relieved of their symptoms without any complication. Follow-up MRI revealed continued shrinkage of the cysts after both surgery and MRI-guided percutaneous fenestration. CONCLUSION: MRI-navigated percutaneous aspiration can be a minimally-invasive treatment option for symptomatic cysts of the terminal ventricle, and therefore, can be indicated before more invasive surgery might be scheduled.