Faculty of Medical Science, Department of Orthopaedics and Rehabilitation Medicine, 23-3 Shimoaizuki, Matsuoka, Eiheiji, Fukui, 910-1193 Japan.
Joint Bone Spine. 2010 Mar;77(2):184-6. doi: 10.1016/j.jbspin.2009.09.009. Epub 2010 Feb 6.
Discal cyst of the lumbar spine is a very rare cause of back pain and sciatica. We report two cases of discal cysts communicating with an adjacent herniated disc. From CT and MRI findings, they were diagnosed as having a discal cyst in the epidural space, which compressed the nerve root. After an adequate surgical field was obtained with a microscope and a Casper retractor, the discal cyst could be excised and satisfactory decompression of the adjacent nerve root was obtained. From histological and electron microscopic study, the presence of residual herniated tissues was confirmed in the cyst wall. Macrophages played an important role in the absorption of herniated tissue and the formation of the discal cyst. Hemorrhage in the cyst wall will make the serous hemorrhagic fluid-filled cystic structure in the absorbed spaces of the prolapsed disc. In this study, we confirmed that the discal cyst could have developed from the absorption process of a disc herniation.
腰椎间盘囊肿是一种非常罕见的腰痛和坐骨神经痛病因。我们报告了两例与相邻椎间盘突出症相通的椎间盘囊肿。根据 CT 和 MRI 结果，诊断为硬膜外间隙椎间盘囊肿，压迫神经根。在显微镜和 Casper 牵开器的辅助下获得充分的手术视野后，可切除椎间盘囊肿，并获得相邻神经根的满意减压。组织学和电子显微镜研究证实，囊肿壁内存在残留的疝出组织。巨噬细胞在疝出组织的吸收和椎间盘囊肿的形成中起重要作用。囊肿壁内的出血会使突出椎间盘吸收间隙内形成浆液血性液体积液的囊性结构。在本研究中，我们证实椎间盘囊肿可能是从椎间盘突出的吸收过程中发展而来。
