Sei Akira, Mizutamari Masaya, Fujimoto Toru, Taniwaki Takuya, Mizuta Hiroshi
Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Kumamoto University, Honjo, Japan.
Spine J. 2009 Jul;9(7):e6-8. doi: 10.1016/j.spinee.2009.01.010. Epub 2009 Feb 28.
There have only been four reports of gas-filled intradural cysts, and the pathogenesis is unknown.
To document the radiologic and histopathologic features of gas-filled intradural cysts and to discuss the pathogenesis with a review of the literature.
Case report.
A 67-year-old woman, admitted to our institute, presented with severe right thigh pain. On admission to the institute, enhanced magnetic resonance imaging, showed a cystic lesion in the spinal canal at the L2-L3 level, with an intensity suggesting the presence of gas. An enhanced region around the cyst was noted. Computed tomography after discography also revealed a water-soluble contrast filled the subarachnoid space and area around the cyst, but not inside.
The cyst was surgically resected. One of the nerve roots was firmly adherent to the gas-filled cyst. The cyst wall comprised fibrous tissue, including small granulations and herniated disc material.
Gas-filled intradural cysts are rare. The pathogenesis appears to involve gas in a degenerated intervertebral disc, and spontaneous absorption of herniated disc material.
仅有4例关于硬膜内充气囊肿的报道，其发病机制尚不清楚。
记录硬膜内充气囊肿的放射学和组织病理学特征，并通过文献复习讨论其发病机制。
病例报告。
一名67岁女性因严重右大腿疼痛入住我院。入院时，增强磁共振成像显示L2-L3水平椎管内有一个囊性病变，信号提示有气体存在。囊肿周围有强化区域。椎间盘造影后的计算机断层扫描也显示水溶性造影剂填充了蛛网膜下腔和囊肿周围区域，但未填充囊肿内部。
囊肿经手术切除。其中一根神经根与充气囊肿紧密粘连。囊肿壁由纤维组织组成，包括小颗粒和突出的椎间盘物质。
硬膜内充气囊肿罕见。其发病机制似乎涉及退变椎间盘中的气体以及突出椎间盘物质的自发吸收。
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