case_images: PMC10316147_01
case_images: Preoperative magnetic resonance images obtained in the patient. T2-weighted sagittal (a) revealed a "scalpel sign" at the T7 segment (red arrow). The T7 axial image (b) showed spinal cord deviation (red arrow).
case_images: SNI-14-210-g001.jpg
case_images: PMC10316147_01_SNI-14-210-g001.jpg
case_images: F1
case_images: On the T2-weighted sagittal image, there was a sharp dorsal indentation of the spinal cord consistent with the positive "scalpel sign" [Figures 1a and b].
case_images: (a) Intraoperative visualization of the arachnoid web following a T7 durotomy to expose the web (arrow). (b) Indentation of the cord (arrowheads) following lysis of the arachnoid tissue band.
case_images: SNI-14-210-g002.jpg
case_images: PMC10316147_01_SNI-14-210-g002.jpg
case_images: F2
case_images: The dura was exposed in the midline, and the arachnoid web (AW) was immediately visualized [Figure 2a]. T7 level was carefully microdissected under a surgical microscope, and adherent fibrous tissue was carefully and meticulously removed freeing the cord [Figure 2b]. The T6-T8 fusion utilized fixed plates and titanium screws. The histological findings were consistent with a DAW and included low columnar epithelial cells and fibrous tissue but no malignant cells.
case_images: (a and b) Postoperative sagittal and axial magnetic resonance imaging showed vanished "scalpel sign" and no spinal cord deviation.
case_images: SNI-14-210-g003.jpg
case_images: PMC10316147_01_SNI-14-210-g003.jpg
case_images: F3
case_images: MRI 6 months after surgery showed that the scalpel sign had disappeared, and the spinal cord was no longer deviated [Figure 3].