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Klaus C. Mende, Theresa Krätzig, Malte Mohme, Manfred Westphal, and Sven O. Eicker

S pinal tumors are rare and diverse neoplasms accounting for about 2%–4% of all tumors of the central nervous system. 5 Intradural lesions make up 40%–45% of these lesions, but only approximately 5% are intramedullary, with the remaining lesions being extramedullary. 2 Complete resection of these lesions is the gold-standard treatment, especially for tumors with less aggressive potential, such as meningiomas, neuromas, or ependymomas. 5 Consequently, sufficient exposure for visibility and maneuvering space are essential to this type of surgery. To ensure that

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Shima Shahjouei, Sara Hanaei, Farideh Nejat, Maryam Monajemzadeh, and Mostafa El Khashab

T eratomas are made up of 3 embryonic layers giving rise to a wide range of tissues. 11 Sacrococcygeal teratoma (SCT) is the most common type of fetal teratoma, with great diversity in the degrees of maturity and invasiveness. 7 In most patients with SCT, the tumor is successfully removed along with coccyx. Intradural invasion or extension of SCT is not common, and only a few cases have been reported previously ( Table 1 ). Most patients with intradural teratoma have a pure teratoma without an associated sacrococcygeal lesion. 10 , 13–16 Permanent

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Ziev B. Moses, Gabriel N. Friedman, David L. Penn, Isaac H. Solomon, and John H. Chi

I ntradural spinal arachnoid cysts (SACs) are rare lesions that can eventually lead to spinal myelopathy caused by syringomyelia or spinal cord compression. 23 , 24 These cysts are thought to be primarily congenital, although secondary causes, such as trauma, 6 lumbar puncture, 10 and spinal surgery, 17 have been reported as well. Presenting symptoms typically include pain, weakness, numbness, and urinary dysfunction. 1 , 22 In the literature, approximately 80% of intradural SACs are found at the level of the thoracic spinal cord, whereas 15% are located in

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Kunal P. Raygor, Khoi D. Than, Dean Chou, and Praveen V. Mummaneni

S pinal tumors are exceedingly rare, with an incidence between 1 and 10 per 100,000 people. 3 , 5 , 10 , 14 Gross-total resection, the treatment of choice for intradural-extramedullary neoplasms, has historically been performed via an open surgical technique using a posterior laminectomy or hemilaminectomy. These open approaches have led to excellent outcomes 6 but are associated with more tissue injury and blood loss than newer, alternative techniques. While a number of minimally invasive approaches have been described, we prefer the minimally

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Ananya Chakravorty, Ronald T. Murambi, and Ravi Kumar V. Cherukuri

C alcium pyrophosphate dihydrate (CPPD) crystal deposition disease, also known as pseudogout, is a crystalline arthropathy generally affecting large joints and periarticular tissue. 1 It rarely affects the spine and tends to be limited to extradural articular, ligamentous, and soft-tissue structures when it does. Only one case of intradural CPPD disease has been reported in the literature. We present the second reported case of intradural CPPD disease masquerading as an intradural extramedullary spinal tumor. Case Report An 81-year-old man

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Ravi H. Gandhi and John W. German

I ntradural pathology of the spine consists of oncological and nononcological lesions. Either pathology can be divided into intramedullary and extramedullary lesions. The most common intramedullary pathology consists largely of glial tumors, but other neoplasms such as hemangioblastomas, metastatic lesions, and benign pathological processes can be seen. Extramedullary, intradural pathology includes neoplasms (nerve sheath tumors and meningiomas) as well as nononcological lesions such as arachnoid cysts, tethered cord, and syringomyelia. Clinical

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Andrei F. Joaquim and K. Daniel Riew

P osterior cervical approaches for the treatment of intradural spinal lesions, such as intramedullary or extramedullary tumors, require posterior decompressive techniques. Cervical spine deformity secondary to sagittal and/or coronal imbalance after a laminectomy may result in important cervical pain and functional deterioration, along with neurological deficits in the most severe cases. 2 , 10 , 21 In general, the majority of deformities secondary to cervical laminectomy occur in the sagittal plane, resulting in cervical kyphosis. 9 , 14 Many risk

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Jeremy Steinberger, Dominic A. Nistal, and Saadi Ghatan

present the case of a patient who had no cutaneous involvement of IH and who presented with a T3 hemangioma involving the epidural, intradural extramedullary, and intradural intramedullary spaces. The patient’s presentation and endovascular, operative, and postoperative courses are discussed. Case Report Presentation and Initial Management A 3-year-old female born at 29 weeks’ gestation via cesarean section, complicated by intrauterine fetal demise of the other twin, presented from abroad for evaluation and management of a left upper lobe pulmonary IH with spinal

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Yusuke Nishimura, Masahito Hara, Atsushi Natsume, Yasuhiro Nakajima, Ryuichi Fukuyama, Toshihiko Wakabayashi, and Howard J. Ginsberg

V ascular lesions comprise approximately 6%–7% of all spinal intradural tumors. 12 Spinal vascular malformations may be classified as capillary telangiectasias, cavernous angiomas, arteriovenous malformations, or venous angiomas. 9 Venous angiomas are the most frequently encountered cerebral vascular malformations, with an incidence of up to 2.6% in a series of 4069 brain autopsies. 14 However, spinal venous angiomas are extremely rare lesions. Only 2 previous reports of spinal epidural venous angiomas 3 , 9 have been found, but a previous report on

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Mazda Keki Turel, Wilson Prashanth D’Souza, and Vedantam Rajshekhar

on imaging was undoubtedly intradural and extramedullary, even if it had an extradural/extraforaminal extension, provided it was not > 3 vertebral bodies long. It is our experience that, if studied carefully, the radiological data will reveal that these tumors are almost always eccentric, and the laterality of the tumor guides us in choosing the side of the approach. However, one should always be prepared to abandon the minimally invasive approach for the traditional approach if decompression of the tumor is not possible because of its consistency, if the tumor has