髄膜憩室と思われる巨大なる脊髄硬膜外嚢腫の症例

A Case of Huge Spinal Extradural Cyst, Suggestive of a Meningeal Diverticulum

緒言

　脊髄腫瘍は幾多先人の努力により診断，治療共に著しい進歩普及をみているが，最近私共は硬膜外に発生した極めて稀有な単純性巨大嚢腫を経験し，手術により著効を治めたので報告する。

Y. T., a school girl, aged 14, developed numb-ness of the right ankle and sensory disturban-ces of both lower extremities which began eight months prior to her admission to the hospital. But she had no pain nor disturbances of the bowell or bladder functions. The pati-ent's general condition was good.

Paresis of both lowerextremities, especially of the right ankle jerk was absent. Hypesthesia was seen below the knees, and anethesia below the ankles. Lumbar puncture revealed an incomplete block of the subarachnoidal space on Queckenstedt's test.

Roentgenograms of the spine showed round kyphosis of the thoraco lumbar region and marked enlargement of the spinal canal from the 10th thoracic to the 1st lumbar vertebra. Myelograms showed an incomplete extradual obstruction at the level of the 10th thoracic vertebra.

Laminectomy was done and a large extradu-ral cyst extending from the upper border of the 9th thoracic vertebra to the lower border of the 2nd lumbar vertebra, measuring 12×1.5 cm, was found and removed. The cyst was attached to the dural sac near the right exit of the 12th thoracic spinal root with a short pedjele. When the pedicle was divided a small slit was left on the dural sac, from which spinal fluid spilled out. Microscopic findings of the wall of the cyst consisted of dense collagenous fibers and its inner surface was lined with flat cells.

One year after the operation, physical condi-tion of the patient showed no abnormality, except marked round kyphosis.