Miwa Masahiko, Doita Minoru, Takayama Hiroyuki, Muratsu Hirotsugu, Harada Toshihiko, Kurosaka Masahiro
Department of Orthopaedic Surgery, Hyogo Prefectural Kakogawa Hospital, Hyogo, Japan.
J Spinal Disord Tech. 2004 Aug;17(4):331-3. doi: 10.1097/01.bsd.0000095892.46978.6e.
Synovial cysts of the cervical spine occur infrequently in the spinal canal and are most often associated with degenerative facet joints. Despite the prevalence of degenerative spinal disease, symptomatic synovial cysts are extremely uncommon. We report a rare case that showed an exacerbation of a cervical radiculopathy due to an acute expansion of the synovial cyst. Magnetic resonance (MR) images originally revealed a small cystic extradural lesion when the patient presented with neck pain and slightly numbness in the right hand. The patient's complaints subsequently subsided after administration of pain killers. However, 2 weeks after this, the patient experienced a spontaneous, sudden, severe radiating pain into the right arm without any accompanying cervical injury. MR images showed that the cyst had become markedly increased in size in the intervening 4 weeks and compressed the spinal cord laterally. Because the arm pain was so severe and neurologic examinations revealed the paralysis of the C8 nerve root, the synovial cyst was excised surgically and a good clinical outcome achieved. Thus, even if symptoms are mild and the size of the synovial cyst is small, acute expansion of the cyst might be rarely observed and careful management, including surgical consideration, is needed.
颈椎滑膜囊肿在椎管内很少见，且最常与退行性小关节相关。尽管退行性脊柱疾病很常见，但有症状的滑膜囊肿极为罕见。我们报告一例罕见病例，该病例显示由于滑膜囊肿急性扩张导致颈神经根病加重。患者出现颈部疼痛和右手轻度麻木时，磁共振（MR）图像最初显示硬膜外有一个小的囊性病变。服用止痛药后，患者的症状随后缓解。然而，在此之后的2周，患者在没有任何颈部损伤的情况下，突然自发地出现严重的右臂放射性疼痛。MR图像显示，在这期间的4周内囊肿大小明显增加，并向外侧压迫脊髓。由于手臂疼痛非常严重，神经检查显示C8神经根麻痹，因此对滑膜囊肿进行了手术切除，并取得了良好的临床效果。因此，即使症状轻微且滑膜囊肿较小，囊肿的急性扩张也可能很少见，需要仔细管理，包括考虑手术治疗。
