Pediatrics spinal dural diverticulum: A case-based review of nosology, pathophysiology and microsurgical management

Background: Spinal dural diverticula (SDD), historically identified as spinal extradural arachnoid cysts (SEACs), are rare but significant causes of myelopathy in children. These lesions result from a focal dural defect that facilitates arachnoid herniation and subsequent cerebrospinal fluid (CSF) accumulation.
Case Description: An 11-year-old boy presented with a 4-month history of progressive spastic paraparesis (sensory level T4). Thoracolumbar MRI revealed a T4–T7 extradural cystic lesion causing spinal cord compression. Microsurgical exploration via laminoplasty identified a lateral dural defect. Following ligation of the communication and in toto resection, the patient achieved complete neurological recovery.
Conclusion: Modern nomenclature favors the term "dural diverticulum" over "arachnoid cyst." Surgical success depends on the meticulous identification and ligation of the communicating ostium to prevent recurrence.