Dataset Information

Full endoscopic treatment of unusual spontaneous degenerative epidural cyst: A case report.

ABSTRACT:

Background

Extensive studies have been performed about the synovial cyst and intraspinal extradural ganglion cyst. Here, we describe a new type of the cyst with entirely different histological characteristics, which we are now calling a "Spontaneous Degenerative Epidural Cyst."

Case description

A 74-year-old male presented with low back pain, bilateral lower extremity radiculopathy, and a cauda equina syndrome. He exhibited a partial left foot drop (Grade 3/5) and hypoesthesia in the sacral region. The magnetic resonance imaging (MRI) showed two cysts at the L4-L5 level; Cyst I was in the left foramen and Cyst II was within the epidural space between the dura and ligamentum flavum. Cyst I was removed through an endoscopic transforaminal approach; it originated from the left facet joint and with synovial lining was confirmed to be a synovial cyst. Cyst II required an endoscopic interlaminar approach, and pathology revealed granulation tissue with micro-calcification, woven bone formation, hemosiderin pigment, and focal cystic change consistent with our designation "Spontaneous Degenerative Epidural Cyst."

Conclusion

"Spontaneous Degenerative Epidural cyst" should be considered among the differential diagnostic consideration for the different lumbar cysts. High-resolution MRI is the most useful in diagnosing these lesions, while full endoscopic treatment provides for adequate resection of these lesions.

SUBMITTER: Kim HS

PROVIDER: S-EPMC6743682 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Full endoscopic treatment of unusual spontaneous degenerative epidural cyst: A case report.

Kim Hyeun-Sung HS Singh Ravindra R Adsul Nitin N Bang Jung-Soo JS Park Chang-Hwang CH Jang Il-Tae IT

Surgical neurology international 20190424

<h4>Background</h4>Extensive studies have been performed about the synovial cyst and intraspinal extradural ganglion cyst. Here, we describe a new type of the cyst with entirely different histological characteristics, which we are now calling a "Spontaneous Degenerative Epidural Cyst."<h4>Case description</h4>A 74-year-old male presented with low back pain, bilateral lower extremity radiculopathy, and a cauda equina syndrome. He exhibited a partial left foot drop (Grade 3/5) and hypoesthesia in ...[more]

PMID: 31528396

Similar Datasets

Project description:BackgroundSynovial cysts are benign fluid-filled sacs commonly found in the degenerative lumbar spine. Few studies have reported the detailed epidemiology and standardized therapy for this disease. Conservative treatment is recommended if synovial cysts are asymptomatic or show mild clinical symptoms. If percutaneous facet joint steroid injections are ineffective or neurologic symptoms are aggravated, the open decompression with additional fusion is the reasonable surgical strategy to remove the pain generator. Furthermore, the synovial cysts that occur at the cervicothoracic spine are infrequently, especially accompanied by hemorrhagic radiographic evidence. Therefore, we describe the efficacy and safety of the full-endoscopy surgical procedure assisted by intraoperative O-arm navigation guidance to manage C7/T1 spinal synovial cysts.Case descriptionWe describe a 71-year-old male patient diagnosed with cervicothoracic hemorrhagic synovial cysts. The pathologic site is located at the posterior side of the C7 vertebral body to the medial side of the C7-T1 left facet joint. Herein is described a step-by-step protocol for the full-endoscopic procedure via the posterior approach to remove the lesions under intraoperative O-arm navigation guidance.OutcomeThe patient was successfully treated via full-endoscopic removal of the synovial cysts guided by intraoperative O-arm navigation. Intraoperative bleeding of 30 mL occurred, and the operative time was 150 minutes. The patient's sensory strength improved, and no opioid medicine was required with no complications postoperatively. One-year follow-up magnetic resonance imaging (MRI) and computed tomography (CT) scans showed no synovial cyst recurrence.ConclusionsFull-endoscopy assisted with intraoperative O-arm navigation guidance improves precision and safety in treating patients with synovial cysts of the cervicothoracic spine. The O-arm navigation system improves the efficiency and safety of intraoperative positioning at the cervicothoracic lesion and reduces radiation exposure to the surgeons. Meanwhile, this technique preserves the range of cervicothoracic motion and facilitates the patient return to normal life.

Dataset Information

Full endoscopic treatment of unusual spontaneous degenerative epidural cyst: A case report.

Background

Case description

Conclusion

Publications

Full endoscopic treatment of unusual spontaneous degenerative epidural cyst: A case report.

Similar Datasets

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