AIMS: Spinal extradural meningeal cyst (EMC) aetiology remains unclear. Based on our in-depth analysis of EMC clinical characters, we propose the alternative term 'dural dissection cyst' (DDC), which is more consistent with its aetiology and pathological manifestations. METHODS: We examined the clinical, imaging and operative findings of four patients with spinal EMC (type I A) and analysed the aetiology and treatment of the cyst. RESULTS: Spinal DDC was observed between T10 and L3 in our series. Patients presented with low back pain, lower extremity numbness and weakness, and segmental muscle atrophy. Small clefts were found on the inner wall of all cysts. Microscopic suture of the cleft successfully improved patient's symptoms and neurological deficits. CONCLUSIONS: Spinal EMC (type I A) is characterized by dural dissection, so the term DDC can best reflect its aetiology. Because it is a dissection cyst, the most reasonable treatment is to suture the fistula.
AIMS: Spinal extradural meningeal cyst (EMC) aetiology remains unclear. Based on our in-depth analysis of EMC clinical characters, we propose the alternative term 'dural dissection cyst' (DDC), which is more consistent with its aetiology and pathological manifestations. METHODS: We examined the clinical, imaging and operative findings of four patients with spinal EMC (type I A) and analysed the aetiology and treatment of the cyst. RESULTS: Spinal DDC was observed between T10 and L3 in our series. Patients presented with low back pain, lower extremity numbness and weakness, and segmental muscle atrophy. Small clefts were found on the inner wall of all cysts. Microscopic suture of the cleft successfully improved patient's symptoms and neurological deficits. CONCLUSIONS: Spinal EMC (type I A) is characterized by dural dissection, so the term DDC can best reflect its aetiology. Because it is a dissection cyst, the most reasonable treatment is to suture the fistula.