Manabe Michihiko, Doita Minoru, Yoshikawa Masaho, Okamoto Koji, Sha Norihide, Kurosaka Masahiro
Department of Orthopedic Surgery, Kanebo Memorial Hospital, Japan.
J Spinal Disord Tech. 2006 Aug;19(6):447-50. doi: 10.1097/00024720-200608000-00013.
Most synovial cysts of the lumbar spine appear as intraspinal extradural masses adjacent to the facet joint. Almost all symptomatic synovial cysts are located within the spinal canal and or the neural foramen. To our knowledge, only 6 cases of symptomatic extraspinal synovial cysts have been described in the literature. The authors report a case of lumbar radiculopathy caused by a synovial cyst located in the far lateral extraforaminal area. The patient underwent decompression of the L5 nerve root with recapping right isthmectomy and facetectomy. Postoperative recovery was uneventful, and the patient was totally pain free with no motor deficit. Symptomatic synovial cysts are uncommon lesions that are associated with degenerative disease of the spine. Juxtafacet cysts should be considered in the differential diagnosis of space-occupying lesions at the extraforaminal areas. Recapping isthmectomy and facetectomy are useful procedures for a synovial cyst located in the far lateral extraforaminal area.
大多数腰椎滑膜囊肿表现为位于小关节旁的椎管内硬膜外肿块。几乎所有有症状的滑膜囊肿都位于椎管内和/或神经孔内。据我们所知，文献中仅描述了6例有症状的椎管外滑膜囊肿。作者报告了1例由位于远外侧椎间孔外区域的滑膜囊肿引起的腰椎神经根病病例。该患者接受了L5神经根减压术，同时进行了右侧峡部修复切除术和小关节切除术。术后恢复顺利，患者完全无痛，无运动功能障碍。有症状的滑膜囊肿是与脊柱退行性疾病相关的罕见病变。在鉴别诊断椎间孔外区域的占位性病变时应考虑关节旁囊肿。对于位于远外侧椎间孔外区域的滑膜囊肿，峡部修复切除术和小关节切除术是有效的手术方法。
