title: Intramedullary and Extramedullary Cervical Neurenteric Cyst Requiring Fixation and Fusion.
abstract: BACKGROUND
  Spinal neurenteric cysts are rare in the literature, described by sporadic case reports and small case series. In the vast majority of cases, these lesions are intradural extramedullary. We report the novel case of a cervical neurenteric cyst that was simultaneously intramedullary and extramedullary.
  
  
  METHODS
  A 47-year-old man underwent C2 through C7 laminectomies for microsurgical resection of a large cystic intradural mass, with C1 through T1 instrumentation and fusion. Gross total resection was obtained. Fusion was necessary after removal of the posterior elements because the vertebrae were thinned extensively and remodeled around the tumor, a treatment paradigm that has not been described adequately for neurenteric cysts previously.
  
  
  CONCLUSIONS
  A novel case of cervical intramedullary and extramedullary neurenteric cyst is presented with clinical, radiographic, and histologic details. Given the potential for bony remodeling around these developmental tumors, the possibility exists for instability after certain neurenteric cysts are resected. Thus, the present case adds fixation and fusion to the potential treatment paradigm for select spinal neurenteric cysts.
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Amy K
authors.initials: AK
authors.lastname: Bruzek
authors.affiliation: Ann Arbor Spine Center, Michigan Brain and Spine Institute, Ypsilanti, Michigan, USA.
authors.forename: Elisa J
authors.initials: EJ
authors.lastname: Kucia
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA; Ann Arbor Spine Center, Michigan Brain and Spine Institute, Ypsilanti, Michigan, USA. Electronic address: moppenla@med.umich.edu.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Oppenlander
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009436:Neural Tube Defects / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Bronchogenic cyst; Neurenteric cyst; Spinal tumor