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Percutaneous Aspiration of Spinal Terminal Ventricle Cysts Using Real-Time Magnetic Resonance Imaging and Navigation

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.