Tekkök Ismail H, Ruacan Sevket
Department of Neurosurgery, MESA Hospital, Ankara, Turkey.
Eur Spine J. 2006 Oct;15 Suppl 5(Suppl 5):610-5. doi: 10.1007/s00586-006-0093-0. Epub 2006 Apr 8.
Dorsal root ganglia are oval enlargements on the dorsal nerve roots and contain the cell bodies of sensory neurons. Asymmetry of dorsal root ganglia may occur naturally, yet natural occurrence of gigantic dorsal root ganglion (DRG) is rare. The patient was 61-year-old woman who presented with atypical symptoms like neuropathic pain and urinary distention. Neuroimaging has shown left L3-4 far-lateral disc herniation and a gigantic L3 DRG. At surgery, the dural sheath of the ganglion had to be opened and a firm, yellow-colored abnormal tissue was exposed. The abnormal tissue considered to be a tumor of neural origin was gross totally excised and the patient's symptoms ceased immediately after surgery. Histopathological examination of the specimen revealed nothing more than normal DRG morphology. At 4 months postoperatively, the patient is well with mild L3 hyperesthesia and hyperalgesia. Dural sheath opening in neurosurgery is not a routine practice. The sheath may need to be opened when surgeon suspects of a tumor, a free disc fragment and any inflammation within the ganglion. Operative morphology of a severely edematous but non-tumoral (pseudotumor) ganglion has not previously been documented.
背根神经节是背神经根上的椭圆形膨大，包含感觉神经元的细胞体。背根神经节的不对称可能自然发生，但巨大背根神经节（DRG）的自然发生情况罕见。该患者为一名61岁女性，表现出如神经性疼痛和尿潴留等非典型症状。神经影像学显示左侧L3 - 4远外侧椎间盘突出以及一个巨大的L3背根神经节。手术中，不得不打开神经节的硬膜鞘，暴露了一个质地坚硬、黄色的异常组织。被认为是神经源性肿瘤的异常组织被整块完全切除，术后患者症状立即消失。标本的组织病理学检查显示无非正常背根神经节形态。术后4个月，患者情况良好，仅有轻度L3感觉过敏和痛觉过敏。神经外科手术中打开硬膜鞘并非常规操作。当外科医生怀疑神经节内有肿瘤、游离椎间盘碎片或任何炎症时，可能需要打开硬膜鞘。此前尚未有严重水肿但非肿瘤性（假瘤）神经节的手术形态学记录。
