Akiyama H, Tamaki N, Kondoh T, Nagashima T
Department of Neurosurgery, Kobe University School of Medicine.
Neurol Med Chir (Tokyo). 1999 Jul;39(7):539-43. doi: 10.2176/nmc.39.539.
A 51-year-old female presented with a rare case of synovial cyst at the cruciate ligament of the odontoid process associated with atlanto-axial dislocation, manifesting as a history of headache and numbness in her left extremities for 5 months, and progressive motor weakness of her left leg. Neuroimaging studies revealed a small cystic lesion behind the dens, which severely compressed the upper cervical cord, and atlanto-axial dislocation. The cyst was successfully removed via the transcondylar approach. C-1 laminectomy and foramen magnum decompression were also performed. Posterior craniocervical fusion was carried out to stabilize the atlanto-axial dislocation. The cyst contained mucinous material. Histological examination detected synovial cells lining the fibrocartilaginous capsule. Synovial cysts of this region do not have typical symptoms or characteristic radiographic features. Careful preoperative evaluation of the symptoms and a less invasive strategy for removal of the cyst are recommended.
一名51岁女性，出现罕见的齿状突十字韧带滑膜囊肿并伴有寰枢椎脱位，表现为头痛及左上肢麻木5个月病史，且左腿进行性运动无力。神经影像学检查显示齿状突后方有一个小囊性病变，严重压迫颈髓上段，同时存在寰枢椎脱位。通过经髁入路成功切除囊肿。还进行了C-1椎板切除术和枕骨大孔减压术。实施了后路颅颈融合术以稳定寰枢椎脱位。囊肿内含有黏液性物质。组织学检查发现纤维软骨囊内衬有滑膜细胞。该区域的滑膜囊肿没有典型症状或特征性影像学表现。建议术前仔细评估症状并采用侵入性较小的囊肿切除策略。
